Provider Demographics
NPI:1689971541
Name:LINDSEY, JENNIFER LYNN (PSYD, CADC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:PSYD, CADC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, CADC
Mailing Address - Street 1:1818 E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5875
Mailing Address - Country:US
Mailing Address - Phone:847-533-8939
Mailing Address - Fax:
Practice Address - Street 1:579 N 1ST BANK DR STE 150
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8102
Practice Address - Country:US
Practice Address - Phone:847-533-8939
Practice Address - Fax:847-907-9994
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-008531103TC2200X
IL071008531103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04515143OtherBLUECROSS BLUESHIELD
IL576560Medicare PIN