Provider Demographics
NPI:1851483119
Name:STRIEDINGER, FERNANDO M (MD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:M
Last Name:STRIEDINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 N DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-1442
Mailing Address - Country:US
Mailing Address - Phone:773-878-6060
Mailing Address - Fax:773-878-7858
Practice Address - Street 1:4733 N DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-1442
Practice Address - Country:US
Practice Address - Phone:773-878-6060
Practice Address - Fax:773-878-7858
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090741207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4932289OtherPROVIDER
IL200752418Medicaid
IL208803Medicare ID - Type UnspecifiedPROVIDER
IL4932289OtherPROVIDER