Healthcare Provider Details

I. General information

NPI: 1588292130
Provider Name (Legal Business Name): KATHERINE J FRIEDMANN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 03/30/2020
Certification Date: 03/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST STE 710
CHICAGO IL
60612-3863
US

IV. Provider business mailing address

1725 W HARRISON ST STE 710
CHICAGO IL
60612-3863
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-3034
  • Fax: 312-942-4168
Mailing address:
  • Phone: 312-942-3034
  • Fax: 312-942-4168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209-020386
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: