Individual provider Active NPI

Jody Y Lin, MD

  • Obstetrics & Gynecology Physician
  • La Grange, IL
National Provider Identifier
1184711640
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036099710 Issued in IL
Practice address
5201 S Willow Springs Rd
Ste 490
Lagrange, IL 60525
Phone
(708) 352-4630
Fax
(708) 352-8348
NPI assigned
Oct 6, 2006
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036099710 IL Primary

Addresses

Primary practice location

5201 S Willow Springs Rd
Ste 490
Lagrange, IL 60525

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036099710MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlin120001@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100414000569 IL Practitioner - Obstetrics/Gynecology 0749315646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

5210 S Willow Springs Rd
Suite 490
Lagrange, IL 60558
Phone (708) 352-4630

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036099710ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 11, 2023 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology CurrentSince Dec 11, 2023 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 18, 2016 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 18, 2016 Accepting new patients
Rush University Medical Center PastSince Nov 28, 2009 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: jlin120001@dulyhealthandcare.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1184711640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 S WILLOW SPRINGS RD",
            "address_2": "STE 490",
            "city": "LAGRANGE",
            "state": "IL",
            "postal_code": "60525",
            "telephone_number": "708-352-4630",
            "fax_number": "708-352-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JODY",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036099710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099710",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlin120001@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Duly Health and Care",
            "address_1": "5201 S Willow Springs Rd",
            "address_2": "Ste 490",
            "city": "LaGrange",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

Verify at the official NPI Registry.