Provider Demographics
NPI:1932159100
Name:DRESSEN, FREDERICK J (DO)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:J
Last Name:DRESSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1105
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1105
Mailing Address - Country:US
Mailing Address - Phone:618-549-5361
Mailing Address - Fax:618-457-4542
Practice Address - Street 1:6 E SHAWNEE DR
Practice Address - Street 2:
Practice Address - City:MURPHYSBORO
Practice Address - State:IL
Practice Address - Zip Code:62966-7048
Practice Address - Country:US
Practice Address - Phone:618-684-1035
Practice Address - Fax:618-687-1155
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036075922208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL360759222Medicaid
IL3932056OtherBCBS
IL26708OtherHEALTH ALLIANCE
IL7210895OtherAETNA
IL269604OtherHEALTHLINK
IL319208OtherGHP
IL214881Medicare PIN
IL3932056OtherBCBS
IL319208OtherGHP
ILE18508Medicare UPIN