MEDICARE: MS. LINDA JEAN BRINKER M.S.W.

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	1041C0700X	Clinical Social Worker	149.008731	IL

General Provider Information

NPI Number	:	1538468335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA JEAN BRINKER M.S.W.

Provider Business Mailing Address
First Line	:	17 N. STATE STREET
Second Line	:	SUITE 1300
City	:	CHICAGO
State	:	IL
Zip	:	60602-3207
Country	:	US
Telephone Number	:	312-939-8622
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 N STATE ST
Second Line	:	SUITE 1300
City	:	CHICAGO
State	:	IL
Zip	:	60602-3315
Country	:	US
Telephone Number	:	312-939-8622
Fax Number	:	312-939-0391

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

Provider Enumeration Date	:	03/18/2011
Last Update Date	:	03/18/2011

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