Provider Demographics
NPI:1508087651
Name:FREEDOM WOODS, INC.
Entity Type:Organization
Organization Name:FREEDOM WOODS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-967-9800
Mailing Address - Street 1:9501 AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-1505
Mailing Address - Country:US
Mailing Address - Phone:847-967-9800
Mailing Address - Fax:847-965-1655
Practice Address - Street 1:9501 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-1505
Practice Address - Country:US
Practice Address - Phone:847-967-9800
Practice Address - Fax:847-965-1655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation