Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | IL |
NPI | 1083628580 |
---|---|
Provider Name | Dr. Arnold M Freeman |
First Address | Buffalo Grove, IL 60089-4006 |
Second Address | Buffalo Grove, IL 60089-4006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |