Healthcare Provider Details

I. General information

NPI: 1871400101
Provider Name (Legal Business Name): LINDA RACZAK LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14722 S NAPERVILLE RD UNIT 110A
PLAINFIELD IL
60544-3302
US

IV. Provider business mailing address

14722 S NAPERVILLE RD UNIT 110A
PLAINFIELD IL
60544-3302
US

V. Phone/Fax

Practice location:
  • Phone: 779-234-9064
  • Fax:
Mailing address:
  • Phone: 779-234-9064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: