Provider Demographics
NPI:1003955261
Name:SALMON, LINDA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:R
Last Name:SALMON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 W PETERSON AVENUE
Mailing Address - Street 2:#550
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646
Mailing Address - Country:US
Mailing Address - Phone:773-736-5300
Mailing Address - Fax:773-736-0882
Practice Address - Street 1:4801 W PETERSON AVENUE
Practice Address - Street 2:#550
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646
Practice Address - Country:US
Practice Address - Phone:773-736-5300
Practice Address - Fax:773-736-0882
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist