Provider Demographics
NPI:1700839354
Name:LAM, LINDA (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1295
Mailing Address - Country:US
Mailing Address - Phone:630-690-4553
Mailing Address - Fax:630-690-2293
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-690-4553
Practice Address - Fax:630-690-2293
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104693207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400187409OtherMEDICARE PTAN (INDIVIDUAL)
IL1617373OtherBCBS OF IL
IL206147OtherMEDICARE PTAN (GROUP)
IL036104693Medicaid
ILF400187409OtherMEDICARE PTAN (INDIVIDUAL)
H65316Medicare UPIN
IL206147OtherMEDICARE PTAN (GROUP)
IL1617373OtherBCBS OF IL