Provider Demographics
NPI:1487064069
Name:STEVEN R. LINDAHL
Entity type:Organization
Organization Name:STEVEN R. LINDAHL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LINDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-202-3610
Mailing Address - Street 1:577 WOODS CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-6820
Mailing Address - Country:US
Mailing Address - Phone:630-202-3610
Mailing Address - Fax:847-658-4381
Practice Address - Street 1:600 SPRING HILL RING RD
Practice Address - Street 2:SUITE #106
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-7300
Practice Address - Country:US
Practice Address - Phone:630-202-3610
Practice Address - Fax:847-658-4381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty