Healthcare Provider Details

I. General information

NPI: 1225193683
Provider Name (Legal Business Name): LINDA LOU KUNTNER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21859 W LAKE DR
ROUND LAKE IL
60073-9605
US

IV. Provider business mailing address

21859 W LAKE DR
ROUND LAKE IL
60073-9605
US

V. Phone/Fax

Practice location:
  • Phone: 847-223-9788
  • Fax: 847-548-4005
Mailing address:
  • Phone: 847-223-9788
  • Fax: 847-548-4005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: