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NPI Code Detail

MEDICARE: WALTER FRIBERG MD

MEDICARE: WALTER FRIBERG MD
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
1208100000XPhysical Medicine & RehabilitationIL

General Provider Information

NPI Number : 1467587949
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER FRIBERG MD
Provider Business Mailing Address
First Line : 293 WOODSTONE CIR
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-6702
Country : US
Telephone Number : 847-459-8563
Fax Number :
Provider Business Practice Location Address
First Line : 4108 N SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2007
Country : US
Telephone Number : 773-529-4913
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 07/08/2007

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