MEDICARE: DR. MIRIAM RUTH FRIEDMAN 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
1	207RR0500X	Rheumatology Physician	036.166933	IL

General Provider Information

NPI Number	:	1811489396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIRIAM RUTH FRIEDMAN MD

Provider Business Mailing Address
First Line	:	1801 W TAYLOR ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-4795
Country	:	US
Telephone Number	:	312-413-5569
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 W TAYLOR ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-4795
Country	:	US
Telephone Number	:	312-413-5569
Fax Number	:

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

Provider Enumeration Date	:	05/31/2018
Last Update Date	:	11/13/2023

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