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NPI Code Detail

MEDICARE: MISS WHITNEY NICOLE LYN MD

MEDICARE: MISS WHITNEY NICOLE LYN 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
1207Q00000XFamily Medicine Physician036-129339IL
2207Q00000XFamily Medicine Physician125.056452IL

General Provider Information

NPI Number : 1447481379
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS WHITNEY NICOLE LYN MD
Provider Business Mailing Address
First Line : 3525 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60653-1019
Country : US
Telephone Number : 312-945-4040
Fax Number : 312-945-4088
Provider Business Practice Location Address
First Line : 3525 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60653-1019
Country : US
Telephone Number : 312-945-4040
Fax Number : 312-945-4088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2009
Last Update Date : 04/26/2021

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Directions to “ MISS WHITNEY NICOLE LYN MD” Practice Location

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