Provider Demographics
NPI:1396839973
Name:FRIEDMAN, YAAKOV (MD)
Entity Type:Individual
Prefix:DR
First Name:YAAKOV
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 N. RICHMOND STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4220
Mailing Address - Country:US
Mailing Address - Phone:773-761-1892
Mailing Address - Fax:773-262-1549
Practice Address - Street 1:PROVIDENT HOSPITAL
Practice Address - Street 2:500 . 51 STREET
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-2400
Practice Address - Country:US
Practice Address - Phone:312-572-2387
Practice Address - Fax:312-572-5902
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360070223207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILB19713Medicare UPIN