Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 036.140610 | IL |
N | 2081P2900X | Pain Medicine | 036.140610 | IL |
NPI | 1104179142 |
---|---|
Provider Name | Dr. Jason Douglas Freeman |
First Address | Chicago, IL 60605-3820 |
Second Address | Chicago, IL 60605-3820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2012 |
Last Update Date | 11/12/2020 |