Provider Demographics
NPI:1528393436
Name:LIND, CHERYL A (EDS)
Entity Type:Individual
Prefix:MR
First Name:CHERYL
Middle Name:A
Last Name:LIND
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 WAUKEGAN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1790
Mailing Address - Country:US
Mailing Address - Phone:847-864-4583
Mailing Address - Fax:847-901-0179
Practice Address - Street 1:1926 WAUKEGAN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-1790
Practice Address - Country:US
Practice Address - Phone:847-864-4583
Practice Address - Fax:847-901-0179
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1893879103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool