MEDICARE: KEVIN LIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	056.008692	IL

General Provider Information

NPI Number	:	1063805026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN LIN

Provider Business Mailing Address
First Line	:	6856 W GOLFVIEW LN
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-2209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6856 W GOLFVIEW LN
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-2209
Country	:	US
Telephone Number	:	708-294-8008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2015
Last Update Date	:	03/13/2015

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Directions to “ KEVIN LIN ” Practice Location

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