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General NPI Number Information
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NPI Number | 1114188208
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Entity Type | Organization
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Legal Business Name | LINDA D RICE PA
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 01/16/2012
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Provider Practice Location Address
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Address Line | 5250 OLD ORCHARD RD SUITE 300
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City | SKOKIE
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State | IL
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Zip | 60077-4460
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Country | US
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Telephone | 847-983-3515
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Fax | 219-926-3524
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Provider Business Mailing Address
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Address Line | PO BOX 2257
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City | CHESTERTON
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State | IN
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Zip | 46304-0357
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Country | US
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Telephone | 847-983-3515
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Fax | 219-926-3524
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LINDA DIANE RICE
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Credential | PH.D.
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Telephone | 301-312-7916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 2428
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License Number State | MD
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