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General NPI Number Information
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NPI Number | 1619163821
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Entity Type | Individual
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Provider Name | JULIA FRIESEN L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 27W140 ROOSEVELT RD STE 206
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City | WINFIELD
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State | IL
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Zip | 60190-1642
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Country | US
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Telephone | 312-965-3715
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Fax | 630-230-4232
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Provider Business Mailing Address
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Address Line | 27W341 SUNNYSIDE AVE
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City | WINFIELD
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State | IL
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Zip | 60190-1446
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Country | US
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Telephone | 312-965-3715
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Fax | 630-230-4232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149-008456
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License Number State | IL
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