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

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

WALTER I. FRIED PH.D., M.D., S.C.

Doing business as

SureVision Eye Centers of Lake County

Practice address

3477 Grand Ave
Gurnee, IL 60031-3734

Phone

(847) 249-4660

Fax

(847) 249-4950

NPI assigned

Sep 26, 2005

Last updated

Jan 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tera Bohringer

Title

Business Office Manager

Phone

(847) 249-4660

Specialties & licenses 1

Addresses

Other names 1

• SureVision Eye Centers of Lake County Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter I Fried, PH.D., M.D.

  • Ophthalmology Physician
  • Gurnee, IL
  • NPI 1497741342
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388707200000",
    "number": "1629064514",
    "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": {
        "organization_name": "WALTER I. FRIED PH.D., M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2014-01-03",
        "status": "A",
        "authorized_official_last_name": "BOHRINGER",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "847-249-4660",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SureVision Eye Centers of Lake County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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.