Kang-Yann Lin, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

36-49957 Issued in IL

Practice address

1616 Grand Ave
Suite a
Waukegan, IL 60085-3600

Phone

(847) 662-5050

Fax

(847) 782-5615

NPI assigned

Aug 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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

• Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
  • NPI 1306937289
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1255324786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 GRAND AVE",
            "address_2": "SUITE A",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853600",
            "telephone_number": "847-662-5050",
            "fax_number": "847-782-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 GRAND AVE",
            "address_2": "SUITE A",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853600",
            "telephone_number": "847-662-5050",
            "fax_number": "847-782-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "KANG-YANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "36-49957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049957",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04900703",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna M Levy, M.S.ED
• Albert Ya-Dek Liao, O.D.
• Melanie Lima
• Cecilia Limon
• Jwojiun Lin, RN,BSN,MPH
• Cynthia Everet Nichola Lincke, MSW, LCSW
• Matthew Lindemeier
• Little City Foundation
• Dalvin D Little
• Jacqueline M Litvan

• Nephrology Physician in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.