Provider Demographics
NPI:1457487936
Name:GUNDLING, LYNDA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:
Last Name:GUNDLING
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W NIAGARA AVE
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-4636
Mailing Address - Country:US
Mailing Address - Phone:847-301-3524
Mailing Address - Fax:
Practice Address - Street 1:25 W NIAGARA AVE
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-4636
Practice Address - Country:US
Practice Address - Phone:847-301-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01636469OtherBCBS