MEDICARE: JUDITH FREI APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209016467	IL

General Provider Information

NPI Number	:	1235640186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH FREI APN

Provider Business Mailing Address
First Line	:	600 S PAULINA ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3806
Country	:	US
Telephone Number	:	312-942-6131
Fax Number	:

Provider Business Practice Location Address
First Line	:	2333 W JACKSON BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2957
Country	:	US
Telephone Number	:	312-942-9176
Fax Number	:	312-243-3235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2017
Last Update Date	:	10/18/2017

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Directions to “ JUDITH FREI APN” Practice Location

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