Provider Demographics
NPI:1528066347
Name:FREILICH, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:FREILICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 CENTRAL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5613
Mailing Address - Country:US
Mailing Address - Phone:847-433-4409
Mailing Address - Fax:847-433-4495
Practice Address - Street 1:806 CENTRAL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5613
Practice Address - Country:US
Practice Address - Phone:847-433-4409
Practice Address - Fax:847-433-4495
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036052965207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4067808OtherAETNA / US HEALTHCARE HMO
IL036052965Medicaid
IL1538112818OtherCORPORATE NPI
IL036052965OtherBCBS - IL
IL036052965OtherBCBS - IL
IL1538112818OtherCORPORATE NPI
ILK35514Medicare PIN