Provider Demographics
NPI:1568515591
Name:KASKEL, LINDA MATHIAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MATHIAS
Last Name:KASKEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 CRAWFORD AVE
Mailing Address - Street 2:SUITE 118
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4970
Mailing Address - Country:US
Mailing Address - Phone:847-864-2723
Mailing Address - Fax:847-869-6028
Practice Address - Street 1:2530 CRAWFORD AVE
Practice Address - Street 2:SUITE 118
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4970
Practice Address - Country:US
Practice Address - Phone:847-864-2723
Practice Address - Fax:847-869-6028
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001632176OtherBLUE CROSS BLUE SHIELD #
IL200517Medicare ID - Type Unspecified