MEDICARE: HENRY Y LIN MD SC

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	208D00000X	General Practice Physician	207200	IL

General Provider Information

NPI Number	:	1932236122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY Y LIN MD SC

Provider Business Mailing Address
First Line	:	8530 LOVELAND LN
Second Line	:
City	:	PALOS HILLS
State	:	IL
Zip	:	60465-1733
Country	:	US
Telephone Number	:	708-599-5399
Fax Number	:	773-651-7935

Provider Business Practice Location Address
First Line	:	746W 79TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-2424
Country	:	US
Telephone Number	:	773-994-6303
Fax Number	:	773-651-7935

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. HENRY Y LIN
Credential	:	MD
Telephone Number	:	773-994-6303

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	08/22/2020

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