Fried, Walter I

Fried, Walter I is an individual health care provider with primary practice located at 3477 Grand Ave , Gurnee IL 60031-3734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Fried, Walter I can be contacted via phone (847) 249-4660.

Contact Information

Primary practice address
3477 Grand Ave Gurnee IL 60031-3734
Phone: (847) 249-4660
Fax: (847) 249-4950
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036050042 Illinois
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 29201020 Wisconsin

Profile Details

NPI number 1497741342
LBN Legal business name Fried, Walter I
Credentials PH.D., M.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2005
Last updated Jan 3rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497741342 NPPES
Illinois MEDICAID 036050042

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