Individual provider Active NPI

Bradley G Frieswyk, BCBA

  • Behavior Analyst
  • Chicago, IL
National Provider Identifier
1255672838
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-13206 Issued in IL
Practice address
6430 N Central Ave Ste a
Chicago, IL 60646-2943
Phone
(773) 539-7099
Fax
(773) 539-8099
NPI assigned
Mar 7, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-13206 IL Primary

Addresses

Primary practice location

6430 N Central Ave Ste a
Chicago, IL 60646-2943

Mailing address

6430 N Central Ave Ste 207
Chicago, IL 60646-2955
Phone (773) 539-7099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BGF Childrens Therapy, LLC Behavior Analyst CurrentSince May 7, 2024 Accepting new patients
Bradley G Frieswyk BGF Performance Systems Behavior Analyst CurrentSince Apr 28, 2024 Accepting new patients

Locations

6430 N Central Ave
Ste 207
Chicago, IL 60646
Phone (773) 539-7099

6430 N Central Ave
Ste A
Chicago, IL 60646
Phone (312) 806-7937

4801 W Peterson Ave
Ste 512
Chicago, IL 60646
Phone (773) 539-7099

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1255672838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 N CENTRAL AVE STE 207",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606462955",
            "telephone_number": "773-539-7099",
            "fax_number": "833-589-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 N CENTRAL AVE STE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606462943",
            "telephone_number": "773-539-7099",
            "fax_number": "773-539-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIESWYK",
        "first_name": "BRADLEY",
        "middle_name": "G",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-07",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-13-13206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.