Provider Demographics
NPI:1568552883
Name:KRESCA, LINDA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JEAN
Last Name:KRESCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 E NERGE RD
Mailing Address - Street 2:SUITE # N110
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-4804
Mailing Address - Country:US
Mailing Address - Phone:630-893-8980
Mailing Address - Fax:
Practice Address - Street 1:975 E NERGE RD
Practice Address - Street 2:SUITE # N110
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-4804
Practice Address - Country:US
Practice Address - Phone:630-893-8980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C41513Medicare UPIN
675800/P05738Medicare ID - Type Unspecified