Provider Demographics
NPI:1285093849
Name:HELLMICH, LINDA (PHD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HELLMICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 E. 1ST STREET
Mailing Address - Street 2:KATHERINE SHAW BETHEA HOSPITAL
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021
Mailing Address - Country:US
Mailing Address - Phone:815-285-5638
Mailing Address - Fax:815-285-5850
Practice Address - Street 1:403 E. 1ST ST.
Practice Address - Street 2:KSB MEDICAL GROUP
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-6113
Practice Address - Country:US
Practice Address - Phone:815-285-5638
Practice Address - Fax:815-285-5850
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009241103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist