Provider Demographics
NPI:1558015834
Name:MISHU, LINDA M (MSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:MISHU
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KURT
Other - Middle Name:
Other - Last Name:KISWALED
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:6030 N SHERIDAN RD APT 512
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-2929
Mailing Address - Country:US
Mailing Address - Phone:865-805-0666
Mailing Address - Fax:
Practice Address - Street 1:2045 W NORTH AVE STE 2A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5413
Practice Address - Country:US
Practice Address - Phone:773-340-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker