Provider Demographics
NPI:1013068444
Name:RICE, LINDA D (PHD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:D
Last Name:RICE
Suffix:
Gender:F
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 N CLARK ST # 162
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1848
Mailing Address - Country:US
Mailing Address - Phone:202-487-0921
Mailing Address - Fax:312-275-7660
Practice Address - Street 1:151 N MICHIGAN AVE STE 566
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7506
Practice Address - Country:US
Practice Address - Phone:202-487-0921
Practice Address - Fax:312-275-7660
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY10000293103G00000X
MD2428103G00000X
IL071008254103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL071008254OtherPROFESSIONAL LICENSE
IL071008254OtherPROFESSIONAL LICENSE