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NPI Code Detail

MEDICARE: DR. LIN SHI PH.D.

MEDICARE: DR. LIN SHI PH.D.
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
1106H00000XMarriage & Family Therapist166.000566IL

General Provider Information

NPI Number : 1225243827
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LIN SHI PH.D.
Provider Business Mailing Address
First Line : 39W193 ACRES PL
Second Line :
City : GENEVA
State : IL
Zip : 60134-6073
Country : US
Telephone Number : 630-262-1782
Fax Number :
Provider Business Practice Location Address
First Line : 1250 EXECUTIVE PL STE 101
Second Line :
City : GENEVA
State : IL
Zip : 60134-3805
Country : US
Telephone Number : 630-232-7457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 07/08/2007

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