Provider Demographics
NPI:1720305618
Name:RECKERS, LINDA SUE (MA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:RECKERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:SUE
Other - Last Name:RECKERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:5325 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5057
Mailing Address - Country:US
Mailing Address - Phone:630-963-3246
Mailing Address - Fax:630-963-3246
Practice Address - Street 1:5325 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5057
Practice Address - Country:US
Practice Address - Phone:630-963-3246
Practice Address - Fax:630-963-3246
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003389101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor