MEDICARE: FRIEDMAN PLACE

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	310400000X	Assisted Living Facility	001	IL

General Provider Information

NPI Number	:	1235321423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIEDMAN PLACE

Provider Business Mailing Address
First Line	:	5527 N MAPLEWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-6881
Country	:	US
Telephone Number	:	773-989-9800
Fax Number	:	773-989-4889

Provider Business Practice Location Address
First Line	:	5527 N MAPLEWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-6881
Country	:	US
Telephone Number	:	773-989-9800
Fax Number	:	773-989-4889

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. ANN FARNAM LAGORY
Credential	:
Telephone Number	:	773-989-9800

Provider Enumeration Date	:	08/13/2007
Last Update Date	:	07/21/2022

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Directions to “FRIEDMAN PLACE ” Practice Location

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