Active NPI
Louis Frydman, D.D.S.
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1417026477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Practice address
- 6326 S Ashland Ave
Chicago, IL 60636-2725 - Phone
- (773) 778-7813
- Fax
- (847) 781-1551
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Primary |
Addresses
Primary practice location
6326 S Ashland Ave
Chicago, IL 60636-2725
Mailing address
75 Chestnut Ter
Buffalo Grove, IL 60089-6620
Phone (847) 913-1080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019019594 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417026477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 CHESTNUT TER",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600896620",
"telephone_number": "847-913-1080",
"fax_number": "847-781-1551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6326 S ASHLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606362725",
"telephone_number": "773-778-7813",
"fax_number": "847-781-1551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYDMAN",
"first_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.