Individual
DR. LEANNE FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3001 GREEN BAY RD, M/C 160, NORTH CHICAGO, IL 60064-3048
(224) 610-3749
(224) 610-2909
Mailing address
2847 ROSE ST, FRANKLIN PARK, IL 60131-2961
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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