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Individual

WILLIAM A FRESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1801 W TAYLOR ST, SUITE 2E, CHICAGO, IL 60612-4795
(312) 996-7416
Mailing address
840 S WOOD ST, M/C 856, CHICAGO, IL 60612-4325
(312) 413-1884
(312) 413-0243

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036113073
IL
208000000X
Pediatrics Physician
54693
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036113073
IL
05
1841340882
WI
Enumeration date
01/11/2007
Last updated
12/11/2012
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