Provider Demographics
NPI:1952416018
Name:TAYLOR, LINDA S (APN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:S
Other - Last Name:GARVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 HOLLISTER DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5263
Mailing Address - Country:US
Mailing Address - Phone:847-549-1609
Mailing Address - Fax:847-549-1646
Practice Address - Street 1:1800 HOLLISTER DR
Practice Address - Street 2:SUITE 206
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5263
Practice Address - Country:US
Practice Address - Phone:847-549-1609
Practice Address - Fax:847-549-1646
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner