Individual
DR. WALTER I FRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., M.D.
Contact information
Practice address
3477 GRAND AVE, GURNEE, IL 60031-3734
(847) 249-4660
(847) 249-4950
Mailing address
3477 GRAND AVE, GURNEE, IL 60031-3734
(847) 249-4660
(847) 249-4950
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036050042
IL
207W00000X
Ophthalmology Physician
29201020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036050042
—
IL
Enumeration date
09/26/2005
Last updated
01/03/2014
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