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General NPI Number Information
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NPI Number | 1154393494
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC LINKS
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15 COMMERCE DR SUITE 109
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City | GRAYSLAKE
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State | IL
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Zip | 60030-7807
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Country | US
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Telephone | 847-548-3458
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Fax | 847-548-3459
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Provider Business Mailing Address
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Address Line | 15 COMMERCE DR SUITE 109
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City | GRAYSLAKE
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State | IL
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Zip | 60030-7807
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Country | US
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Telephone | 847-548-3458
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Fax | 847-548-3459
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | TRACY LYNDON
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Credential |
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Telephone | 847-548-3458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 056-005-352
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License Number State | IL
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