Provider Demographics
NPI:1134334451
Name:FRIEDMAN, MARTIN (LCSW)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WILMETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2961
Mailing Address - Country:US
Mailing Address - Phone:847-251-0749
Mailing Address - Fax:
Practice Address - Street 1:999 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3224
Practice Address - Country:US
Practice Address - Phone:847-588-8460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical