Individual provider Active NPI

Barry K Freydberg, DDS

  • General Practice Dentistry
  • Skokie, IL
National Provider Identifier
1063597920
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-13513 Issued in IL
Practice address
4833 Church St
Skokie, IL 60077-1357
Phone
(847) 673-7118
Fax
(847) 673-4709
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-13513 IL Primary

Addresses

Primary practice location

4833 Church St
Skokie, IL 60077-1357

Mailing address

291 Whistler Rd
Highland Park, IL 60035-5947
Phone (847) 266-8842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150203001699 IL Order and Referring Only - DentistPractitioner - Dentist 2466777040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-13513ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Webster Dental Care North Suburban LTD General Practice Past Accepting new patients
North Suburban Dental Associates PC General Practice Past Accepting new patients
Sleep Impressions, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063597920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 WHISTLER RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355947",
            "telephone_number": "847-266-8842",
            "fax_number": "847-673-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 CHURCH ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771357",
            "telephone_number": "847-673-7118",
            "fax_number": "847-673-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREYDBERG",
        "first_name": "BARRY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-13513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.