Provider Demographics
NPI:1366587529
Name:FRIEDMAN, JAMIE BETH (SLP)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:BETH
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N. STATE PARKWAY
Mailing Address - Street 2:UNIT 802
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-8657
Mailing Address - Country:US
Mailing Address - Phone:847-507-9958
Mailing Address - Fax:
Practice Address - Street 1:2705 N MILDRED AVE APT 3C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1419
Practice Address - Country:US
Practice Address - Phone:847-507-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146008553235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist