Individual
LINDA A DERUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
467 DEVONSHIRE DR, CHAMPAIGN, IL 61820
(217) 398-4443
Mailing address
2004 ODONNELL DRIVE, CHAMPAIGN, IL 61821
(217) 398-4443
(217) 355-2788
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036081214
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022594
BCBS
IL
Enumeration date
11/06/2006
Last updated
05/16/2018
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