Healthcare Provider Details

I. General information

NPI: 1649962622
Provider Name (Legal Business Name): EAR BAR CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W GRAND AVE STE A
CHICAGO IL
60654-5818
US

IV. Provider business mailing address

330 W GRAND AVE STE A
CHICAGO IL
60654-5818
US

V. Phone/Fax

Practice location:
  • Phone: 312-877-5522
  • Fax: 312-877-5521
Mailing address:
  • Phone: 312-238-9988
  • Fax: 312-238-9918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SEHJIN HAN
Title or Position: MANAGER
Credential: MD
Phone: 312-877-5522