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NPI Code Detail

MEDICARE: ERIC LINDQUIST

MEDICARE: ERIC LINDQUIST
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
1101YM0800XMental Health Counselor180.001234IL

General Provider Information

NPI Number : 1083058812
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC LINDQUIST
Provider Business Mailing Address
First Line : 10725 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60643-3217
Country : US
Telephone Number : 773-875-8803
Fax Number :
Provider Business Practice Location Address
First Line : 10725 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60643-3217
Country : US
Telephone Number : 773-875-8803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2013
Last Update Date : 11/26/2024

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Directions to “ ERIC LINDQUIST ” Practice Location

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