Individual provider Active NPI

Shin Joh, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Streator, IL
National Provider Identifier
1023081882
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Practice address
104 W 6TH St
Streator, IL 61364-2899
Phone
(815) 673-5533
Fax
(815) 673-2554
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X IL Primary

Addresses

Primary practice location

104 W 6TH St
Streator, IL 61364-2899

Mailing address

104 W 6TH St
Streator, IL 61364-2899
Phone (815) 673-5533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036051934ILMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023081882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-5533",
            "fax_number": "815-673-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-5533",
            "fax_number": "815-673-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOH",
        "first_name": "SHIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

Verify at the official NPI Registry.