Provider Demographics
NPI:1073813051
Name:FRIEDMAN, JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1569
Mailing Address - Country:US
Mailing Address - Phone:847-597-2167
Mailing Address - Fax:847-597-2154
Practice Address - Street 1:2503 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1569
Practice Address - Country:US
Practice Address - Phone:847-597-2167
Practice Address - Fax:847-597-2154
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-032295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist