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General NPI Number Information
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NPI Number | 1982986196
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Entity Type | Individual
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Provider Name | LEYLA M FREEMAN
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Gender | Female
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Dates
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Enumeration Date | 09/13/2011
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 1433 W FLOURNOY ST
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City | CHICAGO
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State | IL
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Zip | 60607-3205
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Country | US
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Telephone | 312-375-8883
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Fax | 773-913-2527
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Provider Business Mailing Address
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Address Line | PO BOX 7692
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City | CHICAGO
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State | IL
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Zip | 60680-7692
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Country | US
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Telephone | 312-375-8883
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Fax | 773-913-2527
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | IL
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