Provider Demographics
NPI:1164094074
Name:LINDBLADE, ISABELLE EVELYN
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:EVELYN
Last Name:LINDBLADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7S620 PLAINFIELD NAPERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6465
Mailing Address - Country:US
Mailing Address - Phone:630-730-1274
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27268-0002
Practice Address - Country:US
Practice Address - Phone:336-841-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer