Provider Demographics
NPI:1225280639
Name:KROLL, LINDA B (LINDA KROLL)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:B
Last Name:KROLL
Suffix:
Gender:F
Credentials:LINDA KROLL
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:KROLL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC, JD
Mailing Address - Street 1:400 LAKE COOK ROAD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015
Mailing Address - Country:US
Mailing Address - Phone:847-914-0560
Mailing Address - Fax:
Practice Address - Street 1:400 LAKE COOK RD
Practice Address - Street 2:217
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5607
Practice Address - Country:US
Practice Address - Phone:847-914-0560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002448101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health