Provider Demographics
NPI:1508926197
Name:REMENSNYDER, LINDA STANTON (AUD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:STANTON
Last Name:REMENSNYDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 S MILWAUKEE AVE
Mailing Address - Street 2:SUITE 189
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3267
Mailing Address - Country:US
Mailing Address - Phone:847-680-7580
Mailing Address - Fax:847-680-9168
Practice Address - Street 1:755 S MILWAUKEE AVE
Practice Address - Street 2:SUITE 189
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3267
Practice Address - Country:US
Practice Address - Phone:847-680-7580
Practice Address - Fax:847-680-9168
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL718960Medicare ID - Type Unspecified