Healthcare Provider Details

I. General information

NPI: 1912169277
Provider Name (Legal Business Name): LINDA ANN SKOOG-SLUMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 CLEVELAND RD
HINSDALE IL
60521-4809
US

IV. Provider business mailing address

939 CLEVELAND RD
HINSDALE IL
60521-4809
US

V. Phone/Fax

Practice location:
  • Phone: 630-655-1095
  • Fax: 630-655-1096
Mailing address:
  • Phone: 630-655-1095
  • Fax: 630-655-1096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036086137
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: