Provider Demographics
NPI:1548906332
Name:FRAUCHIGER-ANKERS, REILLY
Entity type:Individual
Prefix:
First Name:REILLY
Middle Name:
Last Name:FRAUCHIGER-ANKERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 W ERIE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-6100
Mailing Address - Country:US
Mailing Address - Phone:248-837-0280
Mailing Address - Fax:
Practice Address - Street 1:1401 W ERIE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-6100
Practice Address - Country:US
Practice Address - Phone:248-837-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program