Fredrick, Mark E
Fredrick, Mark E is an sole proprietor health care provider with primary practice located at 3930 West Washington Street Ste B, Gurnee IL 60031-5702. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Fredrick, Mark E can be contacted via phone (847) 662-1600.Contact Information
Primary practice address
3930 West Washington Street Ste B
Gurnee IL 60031-5702
Phone: (847) 662-1600
Fax: (847) 662-1612
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 038005092 | Illinois |
Profile Details
| NPI number | 1467478404 |
|---|---|
| LBN Legal business name | Fredrick, Mark E |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Oct 6th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467478404 | NPPES |
| Illinois | Other | 4915298 | BCBS IL |
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