Provider Demographics
NPI:1245577345
Name:FRIEDMAN, BAILA SARAH (BSN RN)
Entity Type:Individual
Prefix:
First Name:BAILA
Middle Name:SARAH
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2908 W GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2916
Mailing Address - Country:US
Mailing Address - Phone:773-761-2048
Mailing Address - Fax:
Practice Address - Street 1:2908 W GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-2916
Practice Address - Country:US
Practice Address - Phone:773-793-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041405543163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse