Provider Demographics
NPI:1376533307
Name:FROESE, BETH B (MD)
Entity Type:Individual
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First Name:BETH
Middle Name:B
Last Name:FROESE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:27650 FERRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3845
Mailing Address - Country:US
Mailing Address - Phone:630-225-2663
Mailing Address - Fax:630-225-2399
Practice Address - Street 1:27650 FERRY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3845
Practice Address - Country:US
Practice Address - Phone:630-225-2663
Practice Address - Fax:630-225-2399
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2014-04-01
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Provider Licenses
StateLicense IDTaxonomies
IL036092992208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01130145OtherRR MEDICARE
ILP01130145OtherRR MEDICARE
ILG45282Medicare UPIN