MEDICARE: LINDA LOUISE DEW M.D.

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	2085R0202X	Diagnostic Radiology Physician	C1-0025678	DE
2	2085R0202X	Diagnostic Radiology Physician	35-087115	OH
3	2085U0001X	Diagnostic Ultrasound Physician	01060862A	IN
4	2085R0202X	Diagnostic Radiology Physician	036076744	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036076744	OTHER	IL	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093799884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA LOUISE DEW M.D.

Provider Business Mailing Address
First Line	:	1770 IOWA AVE STE 280
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-7401
Country	:	US
Telephone Number	:	951-786-0801
Fax Number	:	847-680-9391

Provider Business Practice Location Address
First Line	:	1035 CAMPUS DR
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-3834
Country	:	US
Telephone Number	:	847-816-3007
Fax Number	:	847-680-9391

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	08/19/2024

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Directions to “ LINDA LOUISE DEW M.D.” Practice Location

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