Provider Demographics
NPI:1649540014
Name:FRIEDMAN, DANIEL (PSYD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6743 N SHERIDAN RD
Mailing Address - Street 2:APT 2N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4406
Mailing Address - Country:US
Mailing Address - Phone:773-255-0264
Mailing Address - Fax:
Practice Address - Street 1:1557 SHERMAN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4836
Practice Address - Country:US
Practice Address - Phone:773-255-0264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-007954103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL071007954OtherLICENSE