Active NPI
Kwan Bo Jin, M.D.
- Psychiatry Physician
- Hoffman Estates, IL
National Provider Identifier
1376578039
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective May 20, 2010.
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Practice address
- 1650 Moon Lake Blvd
Att: Dr Jin
Hoffman Estates, IL 60194-1010 - Phone
- (847) 882-1600
- Fax
- (847) 358-7516
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | IL | Primary |
Addresses
Primary practice location
1650 Moon Lake Blvd
Att: Dr Jin
Hoffman Estates, IL 60194-1010
Mailing address
PO Box 946
Streamwood, IL 60107-0946
Phone (630) 497-1730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036069415 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Balanced Life SC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Hoffman Estates, IL
- NPI 1730299652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376578039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 946",
"city": "STREAMWOOD",
"state": "IL",
"postal_code": "601070946",
"telephone_number": "630-497-1730",
"fax_number": "630-497-1379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 MOON LAKE BLVD",
"address_2": "ATT: DR JIN",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601941010",
"telephone_number": "847-882-1600",
"fax_number": "847-358-7516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIN",
"first_name": "KWAN",
"middle_name": "BO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hoffman Estates, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.