Provider Demographics
NPI:1699883017
Name:TESSLER, CAROL LINDA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LINDA
Last Name:TESSLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 E ELAINE CIR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-1621
Mailing Address - Country:US
Mailing Address - Phone:847-832-0206
Mailing Address - Fax:
Practice Address - Street 1:1701 E LAKE AVE STE 455
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-5535
Practice Address - Country:US
Practice Address - Phone:847-832-0206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-004112103TC0700X
IL071004112103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL101-05356OtherBLUE CROSS BLUE SHIELD
IL5847008OtherUNITED BEHAVIORAL HEALTH
IL211455Medicare ID - Type UnspecifiedPSYCHOLOGIST
IL101-05356OtherBLUE CROSS BLUE SHIELD