Provider Demographics
NPI:1457373854
Name:HSIA, LINDA M (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:HSIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:636 RAYMOND DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9789
Mailing Address - Country:US
Mailing Address - Phone:630-355-5302
Mailing Address - Fax:630-778-6088
Practice Address - Street 1:636 RAYMOND DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9789
Practice Address - Country:US
Practice Address - Phone:630-355-5302
Practice Address - Fax:630-778-6088
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036065414208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0222075OtherBLUE CROSS GROUP NUMBER
IL363149833OtherTAX IDENTIFICATION NUMBER
IL036065414Medicaid
IL3631498336019001OtherCDPG HFS PAYEE ID
IL367760Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
IL363149833OtherTAX IDENTIFICATION NUMBER