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Organization

FRIEDELL CLINIC, S. C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NELSON VASQUEZ (CFO)
(773) 947-7989
Entity
Organization

Contact information

Practice address
1625 E 75TH ST, CHICAGO, IL 60649-3603
(773) 947-2828
(773) 947-7792
Mailing address
7531 S STONY ISLAND AVE STE 251, CHICAGO, IL 60649-3993
(773) 947-7785
(773) 947-7792

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
042-005610
207Q00000X
Family Medicine Physician
Primary
042-005610
IL
207R00000X
Internal Medicine Physician
042005610
IL
207V00000X
Obstetrics & Gynecology Physician
042-005610
IL
207X00000X
Orthopaedic Surgery Physician
042-005610
IL
207XS0106X
Orthopaedic Hand Surgery Physician
042-005610
IL
207ZF0201X
Forensic Pathology Physician
042-005610
IL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
042-005610
IL
207ZP0213X
Pediatric Pathology Physician
042-005610
IL
208000000X
Pediatrics Physician
042-005610
IL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
042-005610
IL
2084P0800X
Psychiatry Physician
042-005610
IL
208600000X
Surgery Physician
042-005610
IL
208D00000X
General Practice Physician
042-005610
IL
208M00000X
Hospitalist Physician
042-005610
IL

Other

Enumeration date
08/05/2006
Last updated
01/28/2020
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