Individual
DR. LINDA LOUISE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
120 E OGDEN AVE, SUITE 220, HINSDALE, IL 60521-3542
(630) 325-5300
(630) 325-5309
Mailing address
120 E OGDEN AVE, SUITE 220, HINSDALE, IL 60521-3542
(630) 325-5300
(630) 325-5309
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215636
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/21/2006
Last updated
07/08/2007
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