Provider Demographics
NPI:1871889584
Name:HUBBELL, LINDSAY R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:R
Last Name:HUBBELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 DIVERSEY AVE
Mailing Address - Street 2:#315
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614
Mailing Address - Country:US
Mailing Address - Phone:630-824-7020
Mailing Address - Fax:
Practice Address - Street 1:7100 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD PARK
Practice Address - State:IL
Practice Address - Zip Code:60629-5813
Practice Address - Country:US
Practice Address - Phone:708-563-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.294871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist