Provider Demographics
NPI:1073608527
Name:HOOPER, LINDA BARBARA (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:BARBARA
Last Name:HOOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 W. BOUGHTON RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60185
Mailing Address - Country:US
Mailing Address - Phone:630-759-1732
Mailing Address - Fax:
Practice Address - Street 1:404 W. BOUGHTON RD.
Practice Address - Street 2:SUITE B
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60185
Practice Address - Country:US
Practice Address - Phone:630-759-1732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09926786OtherBLUE CROSS PPO NUMBER