Provider Demographics
NPI:1164803342
Name:LANKTREE, BRIGET (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRIGET
Middle Name:
Last Name:LANKTREE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0N199 HOLLAND LN
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4419
Mailing Address - Country:US
Mailing Address - Phone:630-947-6567
Mailing Address - Fax:
Practice Address - Street 1:0N199 HOLLAND LN
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4419
Practice Address - Country:US
Practice Address - Phone:630-947-6567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-14
Last Update Date:2015-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007180103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical