Organization
E KENT FRYE MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE HOUCH (MANAGER PFS)
(815) 673-4603
Entity
Organization
Contact information
Practice address
104 W 6TH ST STE 206, STREATOR, IL 61364-2864
(815) 672-7289
(815) 672-2891
Mailing address
908 PERCY CT, BOURBONNAIS, IL 60914-1884
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036081908
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952392557
NPI
IL
Enumeration date
08/31/2009
Last updated
02/15/2010
Update your record
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