Individual
DUSTIN RYAN FRAIDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
6138 LAKEVIEW PARK DR, LINDEN, MI 48451-9098
(810) 845-5969
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036131110
IL
207RP1001X
Pulmonary Disease Physician
Primary
036.131110
IL
Other
Enumeration date
06/01/2009
Last updated
05/04/2018
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