Organization
LINDA L. HINES, PH.D., PC
Active
Other names
Lakeside Psychology & Counseling Srvcs.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA HINES PH.D. (PRESIDENT)
(847) 604-9441
Entity
Organization
Contact information
Practice address
2213 LAKESIDE DR, BANNOCKBURN, IL 60015-1265
(847) 604-9441
(847) 604-9445
Mailing address
2213 LAKESIDE DR, BANNOCKBURN, IL 60015-1265
(847) 604-9441
(847) 604-9445
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.0066190
IL
103G00000X
Clinical Neuropsychologist
071005286
IL
103T00000X
Psychologist
071005286
IL
103TC0700X
Clinical Psychologist
071004060
IL
103TC0700X
Clinical Psychologist
Primary
071006069
IL
103TC0700X
Clinical Psychologist
071006544
IL
1041C0700X
Clinical Social Worker
149003472
IL
2084P0800X
Psychiatry Physician
036060099
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
337410
LAKESIDE PSYCHOLOGY & COUNSELING SERVICES
IL
01
—
4919478
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/23/2007
Last updated
04/04/2013
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