Provider Demographics
NPI:1477756708
Name:NEIL R FRIEDMAN MD LTD
Entity Type:Organization
Organization Name:NEIL R FRIEDMAN MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-673-6505
Mailing Address - Street 1:4711 W GOLF ROAD
Mailing Address - Street 2:SUITE 910
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1247
Mailing Address - Country:US
Mailing Address - Phone:847-673-6505
Mailing Address - Fax:847-673-6334
Practice Address - Street 1:767 PARK AVENUE WEST
Practice Address - Street 2:SUITE 180
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035
Practice Address - Country:US
Practice Address - Phone:847-432-4066
Practice Address - Fax:847-673-6334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty