Healthcare Provider Details

I. General information

NPI: 1356509541
Provider Name (Legal Business Name): LINDA HARDY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2008
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8170 MCCORMICK BLVD SUITE 204
SKOKIE IL
60076-2961
US

IV. Provider business mailing address

8170 MCCORMICK BLVD SUITE 204
SKOKIE IL
60076-2961
US

V. Phone/Fax

Practice location:
  • Phone: 847-673-0718
  • Fax: 847-673-0875
Mailing address:
  • Phone: 847-673-0718
  • Fax: 847-673-0875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number071007324
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.007324
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: