| NPI | 1699582452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL R FRIED Podiatrist 815-341-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2025-10-10 |