MEDICARE: EAR BAR CLINIC PLLC

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	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1649962622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAR BAR CLINIC PLLC

Provider Business Mailing Address
First Line	:	330 W GRAND AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5818
Country	:	US
Telephone Number	:	312-238-9988
Fax Number	:	312-238-9918

Provider Business Practice Location Address
First Line	:	330 W GRAND AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5818
Country	:	US
Telephone Number	:	312-877-5522
Fax Number	:	312-877-5521

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. SEHJIN HAN
Credential	:	MD
Telephone Number	:	312-877-5522

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	01/16/2025

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