Provider Demographics
NPI:1184226375
Name:LINDER, ILANA LAUREN (JD)
Entity Type:Individual
Prefix:
First Name:ILANA
Middle Name:LAUREN
Last Name:LINDER
Suffix:
Gender:F
Credentials:JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1012
Mailing Address - Country:US
Mailing Address - Phone:513-237-7979
Mailing Address - Fax:
Practice Address - Street 1:2493 WALNUTVIEW CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2456
Practice Address - Country:US
Practice Address - Phone:513-237-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0404439376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0404439Medicaid