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NPI Code Detail

MEDICARE: KENNETH LIN

MEDICARE: KENNETH 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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1841145398
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH LIN
Provider Business Mailing Address
First Line : 3517 S HOYNE AVE UNIT 5
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1159
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4101 LIBERTY BLVD APT 1
Second Line :
City : WESTMONT
State : IL
Zip : 60559-1348
Country : US
Telephone Number : 630-426-9386
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ KENNETH LIN ” Practice Location

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