Provider Demographics
NPI:1053999706
Name:FROST, DANA (FNLP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:FNLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 E RANDOLPH ST APT 3604
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7340
Mailing Address - Country:US
Mailing Address - Phone:847-691-0973
Mailing Address - Fax:
Practice Address - Street 1:360 E RANDOLPH ST APT 3604
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7340
Practice Address - Country:US
Practice Address - Phone:847-691-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date: