Healthcare Provider Details

I. General information

NPI: 1649865486
Provider Name (Legal Business Name): EMILY ROSE FRIEDMAN MSN, APRN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E ERIE ST STE 2450
CHICAGO IL
60611-3926
US

IV. Provider business mailing address

259 E ERIE ST STE 2450
CHICAGO IL
60611-3926
US

V. Phone/Fax

Practice location:
  • Phone: 312-694-9676
  • Fax: 312-472-6580
Mailing address:
  • Phone: 312-694-9676
  • Fax: 312-472-6580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.487454
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number209.022905
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209022905
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: