Provider Demographics
NPI:1912020272
Name:GUILLERMO, LINDA (LCSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:GUILLERMO
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3817
Mailing Address - Country:US
Mailing Address - Phone:847-763-0865
Mailing Address - Fax:847-763-0937
Practice Address - Street 1:7405 KENNETH AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3817
Practice Address - Country:US
Practice Address - Phone:847-763-0865
Practice Address - Fax:847-763-0937
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490065341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical