Provider Demographics
NPI:1568437754
Name:TAYEH, LINDA M (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:TAYEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:TAYEH-KLINSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:233 S GARY AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2213
Mailing Address - Country:US
Mailing Address - Phone:630-924-4009
Mailing Address - Fax:630-924-9671
Practice Address - Street 1:233 S GARY AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2213
Practice Address - Country:US
Practice Address - Phone:630-924-4009
Practice Address - Fax:630-924-9671
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36088523208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36088523Medicaid
IL36088523Medicaid