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General NPI Number Information
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NPI Number | 1497246227
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Entity Type | Individual
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Provider Name | LINDA HUBER PHD
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Gender | Female
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 1541 E FABYAN PKWY STE 101
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City | GENEVA
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State | IL
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Zip | 60134
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Country | US
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Telephone | 630-845-9644
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Fax | 630-845-9678
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Provider Business Mailing Address
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Address Line | 1001 TOM OSBORNE RD
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City | COLUMBIA
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State | TN
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Zip | 38401-6776
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Country | US
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Telephone | 630-624-8295
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 071.009723
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071.009723
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License Number State | IL
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