Provider Demographics
NPI:1053524322
Name:MEDIO, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MEDIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1925
Mailing Address - Country:US
Mailing Address - Phone:803-812-3656
Mailing Address - Fax:
Practice Address - Street 1:3911 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2147
Practice Address - Country:US
Practice Address - Phone:302-764-8192
Practice Address - Fax:302-764-8185
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEP00885359OtherRAILROAD MEDICARE
DE1053824322Medicaid
DE0002266222OtherDPCI
DE3767398000OtherAMERIHEALTH
DE1053824322Medicaid