Provider Demographics
NPI:1942422639
Name:EISERLOH, LINDA BURCH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:BURCH
Last Name:EISERLOH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:MARSHALL
Other - Last Name:BURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3N671 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1131
Mailing Address - Country:US
Mailing Address - Phone:630-665-2771
Mailing Address - Fax:
Practice Address - Street 1:2100 MANCHESTER RD
Practice Address - Street 2:SUITE 945
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4579
Practice Address - Country:US
Practice Address - Phone:630-665-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14900556401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical