Provider Demographics
NPI:1265653026
Name:FRIEDMAN, BONNIE SARA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:SARA
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:BAILA
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:6551 N MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4303
Mailing Address - Country:US
Mailing Address - Phone:773-381-5169
Mailing Address - Fax:773-381-5169
Practice Address - Street 1:6551 N MOZART ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4303
Practice Address - Country:US
Practice Address - Phone:773-381-5169
Practice Address - Fax:773-381-5169
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007328235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist