MEDICARE: DR. HENRY LIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	036046226	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356387559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY LIN MD

Provider Business Mailing Address
First Line	:	8530 LOVELAND LN
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-1733
Country	:	US
Telephone Number	:	773-994-6303
Fax Number	:	773-651-7935

Provider Business Practice Location Address
First Line	:	746 W 79TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-2424
Country	:	US
Telephone Number	:	773-994-6303
Fax Number	:	773-651-7935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. HENRY LIN MD” Practice Location

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