DR. EARL E FREDRICK (M.D.) – Emergency Medicine Physician, NPI 1467452839

DR. EARL E FREDRICK (M.D.) is a healthcare provider. based in Chicago, Illinois. specializing in Emergency Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 036-080103 (IL). The NPI Number for DR. EARL E FREDRICK (M.D.) is 1467452839

Main info

Male
42 Years Of Experience
Accepts Medicare Assignment
Name
DR. EARL E FREDRICK (M.D.)
NPI
1467452839
Phone
(773) 257-6843
Address
1501 S CALIFORNIA AVE
Enumeration Date
28 July 2005
Last Update Date
27 January 2009

Doctor Profile

Medical School Name
HOWARD UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
7739477500
Graduation Year
1984 (42 years ago)
PAC ID
4587638887
Group Practice PAC ID
8527493105
Professional Enrollment ID
I20040823001030
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for DR. EARL E FREDRICK (M.D.)

  • South California Avenue, Brighton Park, Chicago, Cook County, Illinois, 60629, United States

    CHICAGO, IL 606081732

    Phone: (773) 257-6843

    Type: Location

  • 3537 PAYSPHERE CIR

    CHICAGO, IL 606740035

    Phone: (708) 786-2900

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-08-23

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040823001030IEmergency MedicineILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60608)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527493105View full group profile

Reviews

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Frequently asked questions

Is there an official ID for DR. EARL E FREDRICK (M.D.) in U.S. healthcare records?
The official identifier for DR. EARL E FREDRICK (M.D.) is NPI 1467452839.
Is there an active status for DR. EARL E FREDRICK (M.D.)?
For scheduling context, DR. EARL E FREDRICK (M.D.) is shown as active in the registry.
How would a patient describe DR. EARL E FREDRICK (M.D.)'s focus?
For DR. EARL E FREDRICK (M.D.), the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. EARL E FREDRICK (M.D.) associated with Chicago?
Public fields place DR. EARL E FREDRICK (M.D.) around Chicago, Illinois. Always confirm the exact site before visiting.
Does DR. EARL E FREDRICK (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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