Healthcare Provider Details

I. General information

NPI: 1225964133
Provider Name (Legal Business Name): T.LINDAHL THERAPIST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7037 HIDDEN GREEN CIR
FOX LAKE IL
60020-1030
US

IV. Provider business mailing address

7037 HIDDEN GREEN CIR
FOX LAKE IL
60020-1030
US

V. Phone/Fax

Practice location:
  • Phone: 815-690-1133
  • Fax:
Mailing address:
  • Phone: 815-690-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TERESA B LINDAHL
Title or Position: PRESIDENT
Credential: LCSW
Phone: 815-690-1133