Provider Demographics
NPI:1518288679
Name:EDWARD J. FRISCHHOLZ, PH.D., PC
Entity Type:Organization
Organization Name:EDWARD J. FRISCHHOLZ, PH.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRISCHHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PC
Authorized Official - Phone:773-761-6625
Mailing Address - Street 1:6301 N SHERIDAN RD
Mailing Address - Street 2:UNIT C2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1728
Mailing Address - Country:US
Mailing Address - Phone:773-761-6625
Mailing Address - Fax:
Practice Address - Street 1:6301 N SHERIDAN RD
Practice Address - Street 2:UNIT C2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1728
Practice Address - Country:US
Practice Address - Phone:773-761-6625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004383103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty