Individual
DR. MARK E FREDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3930 WEST WASHINGTON STREET, STE B, GURNEE, IL 60031-5702
(847) 662-1600
(847) 662-1612
Mailing address
3930 WEST WASHINGTON STREET, STE B, GURNEE, IL 60031-5702
(847) 662-1600
(847) 662-1612
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038005092
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4915298
BCBS IL
IL
Enumeration date
07/14/2006
Last updated
10/06/2010
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