Provider Demographics
NPI:1093799884
Name:DEW, LINDA LOUISE (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LOUISE
Last Name:DEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 IOWA AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-7401
Mailing Address - Country:US
Mailing Address - Phone:951-786-0801
Mailing Address - Fax:847-680-9391
Practice Address - Street 1:1035 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-3834
Practice Address - Country:US
Practice Address - Phone:847-816-3007
Practice Address - Fax:847-680-9391
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0871152085R0202X
IL0360767442085R0202X
IN01060862A2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036076744OtherBLUE SHIELD
IL036076744Medicaid
ILK27862Medicare ID - Type UnspecifiedMERIDIAN - AREA 99
ILE84257Medicare UPIN
ILK05181Medicare ID - Type UnspecifiedJOLIET OPEN MRI
ILP00279084Medicare ID - Type UnspecifiedRR MEDICARE OYMPIA
ILP00328985Medicare ID - Type UnspecifiedRR MEDICARE MERIDIAN-15
ILK03542Medicare ID - Type UnspecifiedOPEN MRI OLYMPIA FIELDS
ILK16978Medicare ID - Type UnspecifiedBLOOMINGDALE OPEN MRI
ILK27855Medicare ID - Type UnspecifiedMERIDIAN - AREA 16
ILK28070Medicare ID - Type UnspecifiedNORTHSHORE PHYSICIAN GRP
ILP00174714Medicare ID - Type UnspecifiedRRMED-BUCKTOWN OPEN MRI
ILK07039Medicare ID - Type UnspecifiedPEORIA OPEN MRI
ILP00094275Medicare ID - Type UnspecifiedRRMED-S.SUBURBAN ORLAND
ILK02637Medicare ID - Type UnspecifiedS.SUBURBAN MRI ORLAND
ILK06482Medicare ID - Type UnspecifiedBUCKTOWN OPEN MRI
ILK27848Medicare ID - Type UnspecifiedMERIDIAN-AREA 15