Active NPI
Marijo Elizabeth Freedman, O.D.
- Optometrist
- Libertyville, IL
National Provider Identifier
1760561682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Practice address
- 307 S Milwaukee Ave
Libertyville Vision Center
Libertyville, IL 60048-2818 - Phone
- (847) 362-3444
- Fax
- (847) 541-1194
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Primary |
Addresses
Primary practice location
307 S Milwaukee Ave
Libertyville Vision Center
Libertyville, IL 60048-2818
Mailing address
33944 N Wooded Glen Dr
Grayslake, IL 60030-4012
Phone (847) 548-5221
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-009223 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760561682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33944 N WOODED GLEN DR",
"city": "GRAYSLAKE",
"state": "IL",
"postal_code": "600304012",
"telephone_number": "847-548-5221",
"fax_number": "847-541-1194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 S MILWAUKEE AVE",
"address_2": "LIBERTYVILLE VISION CENTER",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600482818",
"telephone_number": "847-362-3444",
"fax_number": "847-541-1194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "MARIJO",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libertyville, 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.