| Doctor Name: | TIMOTHY JOHN FRIEDRICH |
| NPI Number: | 1649434036 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | 135000648 |
| Business Practice Address: | 400 S Kennedy Dr Suite 100 Bradley, IL - 609152682 |
| Business Phone Number: | 8159288050 |
| Business Fax Number: | 8159289858 |
| Mailing Address: | 400 S Kennedy Dr, Suite 100 BRADLEY |
| State: | IL |
| Postal Code: | 609152682 |
| Phone Number: | 8159288050 |
| Fax Number: | 8159289858 |
| NPI Enumeration Date: | 07/15/2008 |
| NPI Last Update Date: | 11/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 135000648 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |