Provider Demographics
NPI:1871954073
Name:BRANDTS, LINDA (RPH)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:BRANDTS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 S ILLINOIS RTE 31
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014
Mailing Address - Country:US
Mailing Address - Phone:779-220-5200
Mailing Address - Fax:779-220-5325
Practice Address - Street 1:875 S ILLINOIS RTE 31
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014
Practice Address - Country:US
Practice Address - Phone:779-220-5200
Practice Address - Fax:779-220-5325
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051287040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist