Individual
MRS. LINDA LOUISE FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(608) 334-1252
Mailing address
675 W NORTH AVE STE 201, MELROSE PARK, IL 60160-1665
(708) 538-5900
(708) 538-5910
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085.004552
IL
Other
Enumeration date
10/25/2010
Last updated
02/03/2022
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