MEDICARE: LOUIS I. FREEMAN D.D.S., PC

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	1223G0001X	General Practice Dentistry	019017492	IL

General Provider Information

NPI Number	:	1497880025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOUIS I. FREEMAN D.D.S., PC

Provider Business Mailing Address
First Line	:	7923 LINCOLN AVE
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-3632
Country	:	US
Telephone Number	:	847-675-7040
Fax Number	:

Provider Business Practice Location Address
First Line	:	7923 LINCOLN AVE
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-3632
Country	:	US
Telephone Number	:	847-675-7040
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LOUIS ISRAEL FREEMAN
Credential	:	D.D.S
Telephone Number	:	847-675-7040

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	10/24/2011

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