Provider Demographics
NPI:1023281854
Name:FREUND, AMY ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:FREUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 E 2200 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:61854-6883
Mailing Address - Country:US
Mailing Address - Phone:217-762-7609
Mailing Address - Fax:
Practice Address - Street 1:1260 E 2200 NORTH RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:IL
Practice Address - Zip Code:61854-6883
Practice Address - Country:US
Practice Address - Phone:217-762-7609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor