Basic Information
| Provider Information | |||||||||
| NPI: | 1104881218 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRYDMAN | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 680 N LAKE SHORE DR | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606114546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126950665 | ||||||||
| FaxNumber: | 3126950050 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 N WESTMORELAND RD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LAKE FOREST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600451673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472344310 | ||||||||
| FaxNumber: | 8472344336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 06/23/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 036124637 | IL | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.