Healthcare Provider Details

I. General information

NPI: 1831297548
Provider Name (Legal Business Name): MALI LIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 N YORK RD SUITE 201
ELMHURST IL
60126-2367
US

IV. Provider business mailing address

386 N YORK ROAD SUITE 201
ELMHURST IL
60126-2367
US

V. Phone/Fax

Practice location:
  • Phone: 630-832-6711
  • Fax: 630-832-6855
Mailing address:
  • Phone: 630-832-6711
  • Fax: 630-832-6855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036057961
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number036-057961
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: