MEDICARE: DR. LINDA D RICE PH.D., ABPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	PSY10000293	DC
2	103G00000X	Clinical Neuropsychologist	2428	MD
3	103G00000X	Clinical Neuropsychologist	071008254	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	071008254	OTHER	IL	PROFESSIONAL LICENSE

General Provider Information

NPI Number	:	1013068444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA D RICE PH.D., ABPP

Provider Business Mailing Address
First Line	:	2506 N CLARK ST # 162
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1848
Country	:	US
Telephone Number	:	202-487-0921
Fax Number	:	312-275-7660

Provider Business Practice Location Address
First Line	:	151 N MICHIGAN AVE STE 566
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-7506
Country	:	US
Telephone Number	:	202-487-0921
Fax Number	:	312-275-7660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2007
Last Update Date	:	03/01/2023

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Directions to “ DR. LINDA D RICE PH.D., ABPP” Practice Location

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