Provider Demographics
NPI:1114542669
Name:DIANE LIN PHD LLC
Entity Type:Organization
Organization Name:DIANE LIN PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:224-662-0015
Mailing Address - Street 1:879 N HAMILTON CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-3483
Mailing Address - Country:US
Mailing Address - Phone:224-662-0015
Mailing Address - Fax:
Practice Address - Street 1:1627 W COLONIAL PKWY STE 302
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4732
Practice Address - Country:US
Practice Address - Phone:224-662-0015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty