Provider Demographics
NPI:1477852887
Name:BRADLEY G FRIESWYK BGF PERFORMANCE SYSTEMS
Entity type:Organization
Organization Name:BRADLEY G FRIESWYK BGF PERFORMANCE SYSTEMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:FRIESWYK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:773-539-7099
Mailing Address - Street 1:6430 N CENTRAL AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-2955
Mailing Address - Country:US
Mailing Address - Phone:773-539-7099
Mailing Address - Fax:833-589-3765
Practice Address - Street 1:6430 N CENTRAL AVE STE 207
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-2955
Practice Address - Country:US
Practice Address - Phone:773-539-7099
Practice Address - Fax:833-589-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty