Provider Demographics
NPI:1689328544
Name:FREEMAN, PAULA (LSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1218
Mailing Address - Country:US
Mailing Address - Phone:630-730-1389
Mailing Address - Fax:
Practice Address - Street 1:800 E DIEHL RD STE 100
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2389
Practice Address - Country:US
Practice Address - Phone:630-577-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.105016104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker