Provider Demographics
NPI:1922158617
Name:FREEMAN, DEBORAH M (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:FREEMAN
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 1:30 UNO CIR
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6632
Mailing Address - Country:US
Mailing Address - Phone:815-773-0766
Mailing Address - Fax:815-773-0764
Practice Address - Street 1:30 UNO CIR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6632
Practice Address - Country:US
Practice Address - Phone:815-773-0766
Practice Address - Fax:815-773-0764
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036055504174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036055504Medicaid
IL0009926176OtherBCBS
IL14D0974334OtherCLIA
IL036055504Medicaid
IL0009926176OtherBCBS
IL14D0974334OtherCLIA