Healthcare Provider Details

I. General information

NPI: 1598891897
Provider Name (Legal Business Name): VALERIE KH LINDGREN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 S WOOD ST DEPARTMENT OF PATHOLOGY
CHICAGO IL
60612-4325
US

IV. Provider business mailing address

840 S WOOD ST DEPARTMENT OF PATHOLOGY
CHICAGO IL
60612-4325
US

V. Phone/Fax

Practice location:
  • Phone: 312-355-3619
  • Fax: 312-413-0156
Mailing address:
  • Phone: 312-355-3619
  • Fax: 312-413-0156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SC0300X
TaxonomyClinical Cytogenetics Physician
License NumberNONE
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: