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General NPI Number Information
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NPI Number | 1447206677
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Entity Type | Individual
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Provider Name | JOHNNY L. LIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/02/2013
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Provider Practice Location Address
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Address Line | 1611 W HARRISON ST # 400
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City | CHICAGO
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State | IL
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Zip | 60612-4861
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Country | US
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Telephone | 312-243-4244
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Fax | 312-942-1517
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Provider Business Mailing Address
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Address Line | 1 WESTBROOK CORPORATE CTR #240
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City | WESTCHESTER
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State | IL
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Zip | 60154-5701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 036115264
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License Number State | IL
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