Provider Demographics
NPI:1003041476
Name:LINDGREN, KEVIN D (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:D
Last Name:LINDGREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S MAPLE AVE STE 5500
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2808
Mailing Address - Country:US
Mailing Address - Phone:708-660-5777
Mailing Address - Fax:708-660-2330
Practice Address - Street 1:610 S MAPLE AVE STE 5500
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2808
Practice Address - Country:US
Practice Address - Phone:708-660-5777
Practice Address - Fax:708-660-2330
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN59927207KA0200X
IL036-129957207KA0200X, 2080P0201X
IL125-56138208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No208000000XAllopathic & Osteopathic PhysiciansPediatrics