Provider Demographics
NPI:1417010687
Name:LENDVAY, TODD RUSSELL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:RUSSELL
Last Name:LENDVAY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26112 W INDIAN TRAIL ROAD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010
Mailing Address - Country:US
Mailing Address - Phone:847-997-2037
Mailing Address - Fax:847-776-4724
Practice Address - Street 1:1644 W COLONIAL PKWY
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-1207
Practice Address - Country:US
Practice Address - Phone:847-997-2037
Practice Address - Fax:847-776-4724
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-07171103TC0700X
IL180002906101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
04932629OtherBLUE CROSS