MEDICARE: DAVID FRECH L.AC, MSTOM

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	171100000X	Acupuncturist	198.001281	IL

General Provider Information

NPI Number	:	1437524576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID FRECH L.AC, MSTOM

Provider Business Mailing Address
First Line	:	4704 N KENMORE AVE APT 4A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5397
Country	:	US
Telephone Number	:	312-498-5867
Fax Number	:

Provider Business Practice Location Address
First Line	:	4704 N KENMORE AVE APT 4A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5397
Country	:	US
Telephone Number	:	312-498-5867
Fax Number	:

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

Provider Enumeration Date	:	12/01/2015
Last Update Date	:	12/01/2015

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