Provider Demographics
NPI:1538541982
Name:FRASER, LINDSEY WOLD (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:WOLD
Last Name:FRASER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDSEY
Other - Middle Name:ANN
Other - Last Name:WOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:71 WAUKEGAN RD STE 700
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-1614
Mailing Address - Country:US
Mailing Address - Phone:847-663-8060
Mailing Address - Fax:847-663-1027
Practice Address - Street 1:71 WAUKEGAN RD STE 700
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1614
Practice Address - Country:US
Practice Address - Phone:847-433-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19517207N00000X, 207NP0225X
IL036153383207N00000X
IL125-066870207R00000X
IL036.153383207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine