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General NPI Number Information
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NPI Number | 1952292864
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Entity Type | Individual
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Provider Name | JASON LIN
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Gender |
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 929 W FOSTER AVE
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City | CHICAGO
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State | IL
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Zip | 60640-1491
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Country | US
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Telephone | 773-433-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 915 W CARMEN AVE APT 206
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City | CHICAGO
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State | IL
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Zip | 60640-6303
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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