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NPI Code Detail

MEDICARE: LAITH FREIJ

MEDICARE: LAITH FREIJ
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
12084N0400XNeurology Physician4301517770MI
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1891322889
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAITH FREIJ
Provider Business Mailing Address
First Line : 912 S WOOD ST RM 174
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4300
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1740 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number : 866-600-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2020
Last Update Date : 06/17/2026

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Directions to “ LAITH FREIJ ” Practice Location

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