Provider Demographics
NPI:1235231846
Name:FRIEDMAN, FREDA B (PHD LCSW)
Entity Type:Individual
Prefix:
First Name:FREDA
Middle Name:B
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 W SCHUBERT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1308
Mailing Address - Country:US
Mailing Address - Phone:773-248-5721
Mailing Address - Fax:773-248-5721
Practice Address - Street 1:445 E OHIO ST
Practice Address - Street 2:SUITE 250
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-245-9501
Practice Address - Fax:312-828-0169
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL149006392104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634386OtherBLUE SHIELD
210836Medicare ID - Type Unspecified