Healthcare Provider Details

I. General information

NPI: 1972846152
Provider Name (Legal Business Name): LINDSEY ELIZABETH TENGERSTROM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7110 WEST 127TH STREET
PALOS HEIGHTS IL
60463-1571
US

IV. Provider business mailing address

7110 WEST 127TH STREET
PALOS HEIGHTS IL
60463-1571
US

V. Phone/Fax

Practice location:
  • Phone: 708-923-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number036146709
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036146709
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number036146709
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: