Provider Demographics
NPI:1770140006
Name:FREEMAN, JULIAN JAY (MD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:JAY
Last Name:FREEMAN
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 1:181 BERRY RD
Mailing Address - Street 2:
Mailing Address - City:NEW DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03855-2416
Mailing Address - Country:US
Mailing Address - Phone:847-433-7030
Mailing Address - Fax:
Practice Address - Street 1:1954 1ST ST.
Practice Address - Street 2:SUITE 263
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035
Practice Address - Country:US
Practice Address - Phone:847-433-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360512252084N0008X, 2084N0400X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology