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General NPI Number Information
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NPI Number | 1932364353
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Entity Type | Organization
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Legal Business Name | LINDA D. SMALL, PH.D AND ASSOCIATES
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 6800 SOUTH MAIN STREET SUITE 14
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3495
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Country | US
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Telephone | 630-968-4300
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Fax | 630-968-4385
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Provider Business Mailing Address
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Address Line | 6800 SOUTH MAIN STREET SUITE 14
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3495
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Country | US
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Telephone | 630-968-4300
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Fax | 630-968-4385
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. LINDA D SMALL
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Credential | PH.D.
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Telephone | 630-968-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036-097047
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License Number State | IL
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