Provider Demographics
NPI:1225123284
Name:SIZEMORE, LINDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-1208
Mailing Address - Country:US
Mailing Address - Phone:847-433-5596
Mailing Address - Fax:847-433-3802
Practice Address - Street 1:3360 BROOK RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-1208
Practice Address - Country:US
Practice Address - Phone:847-433-5596
Practice Address - Fax:847-433-3802
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL346090Medicare ID - Type UnspecifiedPSYCHOLOGIST