Provider Demographics
NPI:1679966246
Name:FRAM, JULIA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:FRAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 W DEMING PL
Mailing Address - Street 2:UNIT 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2668
Mailing Address - Country:US
Mailing Address - Phone:617-510-6555
Mailing Address - Fax:
Practice Address - Street 1:850 REPUBLICAN ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4725
Practice Address - Country:US
Practice Address - Phone:206-543-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS79731602390200000X
IL125.074966208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program