Provider Demographics
NPI:1689259020
Name:FREUND DENTAL PC
Entity Type:Organization
Organization Name:FREUND DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:W
Authorized Official - Last Name:FREUND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-294-9880
Mailing Address - Street 1:1425 LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-5171
Mailing Address - Country:US
Mailing Address - Phone:773-294-9880
Mailing Address - Fax:
Practice Address - Street 1:523 PARK DR
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:IL
Practice Address - Zip Code:60043-1082
Practice Address - Country:US
Practice Address - Phone:847-251-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty