Healthcare Provider Details

I. General information

NPI: 1891826897
Provider Name (Legal Business Name): CHRISTY ANN LINCOLN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTY ANN LINDQUIST LCPC

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3166 N. LINCOLN AVE SUITE 405
CHICAGO IL
60657
US

IV. Provider business mailing address

3166 N. LINCOLN AVE SUITE 405
CHICAGO IL
60657
US

V. Phone/Fax

Practice location:
  • Phone: 773-386-4414
  • Fax:
Mailing address:
  • Phone: 773-386-4414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number180006422
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180006422
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: