Walter I Fried, PH.D., M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036050042 Issued in IL

Practice address

3477 Grand Ave
Gurnee, IL 60031-3734

Phone

(847) 249-4660

Fax

(847) 249-4950

NPI assigned

Sep 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Walter I. Fried PH.D., M.D., S.C.

  • Ophthalmology Physician
  • Gurnee, IL
  • NPI 1629064514
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1497741342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3477 GRAND AVE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313734",
            "telephone_number": "847-249-4660",
            "fax_number": "847-249-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3477 GRAND AVE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313734",
            "telephone_number": "847-249-4660",
            "fax_number": "847-249-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIED",
        "first_name": "WALTER",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036050042",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "29201020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036050042",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald Allen Frank, MD
• Malcolm Fraser, PT
• Mark E Fredrick, DC
• Sarah Rose French-Villarreal
• Fresenius Medical Care Lake County, LLC
• Lisa Lois Fuechtmann, LCPC
• Alyssa Fulton
• Future Sleep Solutions
• Fyzical Gurnee Clinical PLLC
• Dante Polintan Gabriel, MD

• Ophthalmology Physician in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.