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General NPI Number Information
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NPI Number | 1073870382
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Entity Type | Individual
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Provider Name | FREDERICK JEREMY FRANCIS APRN
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Gender | Male
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 315 W ELECTRIC AVE
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City | MCALESTER
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State | OK
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Zip | 74501-3600
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Country | US
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Telephone | 847-235-6130
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Fax | 847-235-6135
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Provider Business Mailing Address
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Address Line | 6348 N MILWAUKEE AVE STE 390
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City | CHICAGO
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State | IL
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Zip | 60646-3728
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Country | US
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Telephone | 847-235-6130
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Fax | 847-235-6135
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0092665
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License Number State | OK
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