Individual
MRS. MARLISE FREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1725 W HARRISON ST, #1118, CHICAGO, IL 60612-3841
(312) 942-5936
(312) 942-2380
Mailing address
1653 W CONGRESS PKWY, #348 MURDOCK, CHICAGO, IL 60612-3833
(312) 942-5939
(312) 942-2238
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-000399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
309-000238
CONTROLLED SUBSTANCE LICE
IL
Enumeration date
08/05/2006
Last updated
03/07/2023
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