Provider Demographics
NPI:1750409983
Name:SUGAR, LINDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:SUGAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 DEMPSTER ST
Mailing Address - Street 2:#1
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-4245
Mailing Address - Country:US
Mailing Address - Phone:847-869-7748
Mailing Address - Fax:847-869-7748
Practice Address - Street 1:636 CHURCH ST
Practice Address - Street 2:SUITE #409
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4508
Practice Address - Country:US
Practice Address - Phone:847-869-7748
Practice Address - Fax:847-869-7748
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490045081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01634463OtherBLUECROSSBLUESHIELDOFIL
IL456027000OtherMAGELLAN
IL456027000OtherMAGELLAN