Provider Demographics
NPI:1134405947
Name:FREEMAN, LOUIS ISRAEL (DDS)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:ISRAEL
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7923 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3615
Mailing Address - Country:US
Mailing Address - Phone:847-675-7040
Mailing Address - Fax:847-675-4335
Practice Address - Street 1:7923 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3615
Practice Address - Country:US
Practice Address - Phone:847-675-7040
Practice Address - Fax:847-675-4335
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019017492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist