Healthcare Provider Details

I. General information

NPI: 1902252513
Provider Name (Legal Business Name): LINDA KOTT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 S RANDALL RD
BATAVIA IL
60510-9470
US

IV. Provider business mailing address

129 S RANDALL RD
BATAVIA IL
60510-9470
US

V. Phone/Fax

Practice location:
  • Phone: 630-879-8858
  • Fax: 630-879-6273
Mailing address:
  • Phone: 630-879-8858
  • Fax: 630-879-6273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051037543
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: