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General NPI Number Information
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NPI Number | 1932236122
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Entity Type | Organization
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Legal Business Name | HENRY Y LIN MD SC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 746W 79TH ST
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City | CHICAGO
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State | IL
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Zip | 60620-2424
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Country | US
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Telephone | 773-994-6303
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Fax | 773-651-7935
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Provider Business Mailing Address
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Address Line | 8530 LOVELAND LN
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City | PALOS HILLS
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State | IL
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Zip | 60465-1733
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Country | US
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Telephone | 708-599-5399
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Fax | 773-651-7935
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HENRY Y LIN
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Credential | MD
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Telephone | 773-994-6303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 207200
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License Number State | IL
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