Provider Demographics
NPI:1588849400
Name:LYNAS, CARMEN MARIA TUMIALAN (MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:MARIA TUMIALAN
Last Name:LYNAS
Suffix:
Gender:F
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W 22ND ST STE 250
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8864
Mailing Address - Country:US
Mailing Address - Phone:630-230-6505
Mailing Address - Fax:
Practice Address - Street 1:600 W 22ND ST STE 250
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-8864
Practice Address - Country:US
Practice Address - Phone:630-230-6505
Practice Address - Fax:630-230-3362
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178002589101YP2500X
IL071007787103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent