Provider Demographics
NPI:1508025057
Name:WHITTAKER, LINDA (MA, LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:WHITTAKER
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 ROSLYN RD
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1629
Mailing Address - Country:US
Mailing Address - Phone:708-747-0625
Mailing Address - Fax:
Practice Address - Street 1:1024 ROSLYN RD
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1629
Practice Address - Country:US
Practice Address - Phone:708-747-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0128251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical