Healthcare Provider Details

I. General information

NPI: 1508524182
Provider Name (Legal Business Name): LINDA DEUBEL LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 12/01/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N DEARBORN ST
CHICAGO IL
60654-3873
US

IV. Provider business mailing address

650 N DEARBORN ST
CHICAGO IL
60654-3873
US

V. Phone/Fax

Practice location:
  • Phone: 847-977-0497
  • Fax:
Mailing address:
  • Phone: 847-977-0497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number27900
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.013529
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: