Provider Demographics
NPI:1477550887
Name:LINDAHL, JEFFREY A (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:LINDAHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1430 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4830
Mailing Address - Country:US
Mailing Address - Phone:847-255-0800
Mailing Address - Fax:847-255-8054
Practice Address - Street 1:1430 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4830
Practice Address - Country:US
Practice Address - Phone:847-255-0800
Practice Address - Fax:847-255-8054
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036076396207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01615768OtherBCBS OF IL
IL01615768OtherBCBS OF IL
IL110230466OtherRAILROAD MEDICARE INDV
ILCK2307OtherRAILROAD MEDICARE GROUP
IL201250Medicare PIN
IL110230466OtherRAILROAD MEDICARE INDV