Healthcare Provider Details

I. General information

NPI: 1003802810
Provider Name (Legal Business Name): ERNEST B. LINDELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1259 RICKERT DR SUITE 101
NAPERVILLE IL
60540-8902
US

IV. Provider business mailing address

1860 PAYSPHERE CIR
CHICAGO IL
60674-0018
US

V. Phone/Fax

Practice location:
  • Phone: 630-355-1300
  • Fax: 630-355-3273
Mailing address:
  • Phone: 630-469-9200
  • Fax: 630-245-9098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036065505
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number036065505
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: