Individual provider Active NPI

Robert A. Freilich, MD

  • Internal Medicine Physician
  • Highland Park, IL
National Provider Identifier
1528066347
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036052965 Issued in IL
Practice address
806 Central Ave
Suite 103
Highland Park, IL 60035-5613
Phone
(847) 433-4409
Fax
(847) 433-4495
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036052965 IL Primary

Addresses

Primary practice location

806 Central Ave
Suite 103
Highland Park, IL 60035-5613

Mailing address

806 Central Ave
Suite 103
Highland Park, IL 60035-5613
Phone (847) 433-4409

Other identifiers 4

IdentifierTypeStateIssuer
4067808OtherILAETNA / US HEALTHCARE HMO
036052965MedicaidIL
1538112818OtherILCORPORATE NPI
036052965OtherILBCBS - IL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036052965ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1528066347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 CENTRAL AVE",
            "address_2": "SUITE 103",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355613",
            "telephone_number": "847-433-4409",
            "fax_number": "847-433-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 CENTRAL AVE",
            "address_2": "SUITE 103",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355613",
            "telephone_number": "847-433-4409",
            "fax_number": "847-433-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREILICH",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036052965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA / US HEALTHCARE HMO",
            "identifier": "4067808",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052965",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NPI",
            "identifier": "1538112818",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - IL",
            "identifier": "036052965",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.