Provider Demographics
NPI:1528579778
Name:BGF CHILDRENS THERAPY, LLC
Entity Type:Organization
Organization Name:BGF CHILDRENS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIESWYK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:773-539-7099
Mailing Address - Street 1:4801 W PETERSON AVE STE 512
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5795
Mailing Address - Country:US
Mailing Address - Phone:773-539-7099
Mailing Address - Fax:
Practice Address - Street 1:4801 W PETERSON AVE STE 512
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5795
Practice Address - Country:US
Practice Address - Phone:773-539-7099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty