MEDICARE: KARL BRIEDRICK LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	178013246	IL

General Provider Information

NPI Number	:	1205355864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL BRIEDRICK LPC

Provider Business Mailing Address
First Line	:	650 N WOOD ST APT 2N
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-6094
Country	:	US
Telephone Number	:	17737260460
Fax Number	:

Provider Business Practice Location Address
First Line	:	935 W CHESTNUT ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5441
Country	:	US
Telephone Number	:	888-726-7170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2017
Last Update Date	:	09/14/2017

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Directions to “ KARL BRIEDRICK LPC” Practice Location

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