Provider Demographics
NPI:1891833109
Name:LINCOLN CENTER FOR CLINICAL SERVICES, LTD
Entity Type:Organization
Organization Name:LINCOLN CENTER FOR CLINICAL SERVICES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIEZER
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUMBEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-433-5427
Mailing Address - Street 1:1954 FIRST STREET #213
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3104
Mailing Address - Country:US
Mailing Address - Phone:847-433-5427
Mailing Address - Fax:847-432-5389
Practice Address - Street 1:1004 SHERIDAN ROAD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-4124
Practice Address - Country:US
Practice Address - Phone:847-433-5427
Practice Address - Fax:847-432-5389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
635610Medicare ID - Type Unspecified