MEDICARE: DR. PAUL DALE LINDEN PSY.D.

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	103TC0700X	Clinical Psychologist	071-004780	IL

General Provider Information

NPI Number	:	1578568622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL DALE LINDEN PSY.D.

Provider Business Mailing Address
First Line	:	111 N WABASH AVE
Second Line	:	STE 1408
City	:	CHICAGO
State	:	IL
Zip	:	60602-3075
Country	:	US
Telephone Number	:	312-499-6873
Fax Number	:	312-443-1307

Provider Business Practice Location Address
First Line	:	111 N WABASH AVE
Second Line	:	STE 1408
City	:	CHICAGO
State	:	IL
Zip	:	60602-3075
Country	:	US
Telephone Number	:	312-499-6873
Fax Number	:	312-443-1307

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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