Provider Demographics
NPI:1619962396
Name:FREEMAN, LINDA M (BSPHARM, MS,FASCP)
Entity Type:Individual
Prefix:PROF
First Name:LINDA
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:BSPHARM, MS,FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1676
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:708-798-9849
Practice Address - Street 1:3805 CARRINGTON DR
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1676
Practice Address - Country:US
Practice Address - Phone:708-798-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-035590183500000X
IN26019982A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist