Individual provider Active NPI

Julian Jwchun Lin, MD

  • Neurological Surgery Physician
  • Peoria, IL
National Provider Identifier
1437104593
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036108766 Issued in IL
Practice address
200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone
(309) 624-4000
Fax
(309) 624-4010
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036108766 IL Primary

Addresses

Primary practice location

200 E Pennsylvania Ave
Peoria, IL 61603-3089

Mailing address

200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone (309) 624-4000

Other identifiers 1

IdentifierTypeStateIssuer
036108766MedicaidIL

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
I20081107000492 IL Practitioner - Neurosurgery 7416016274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Texas Medical School at Houston, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone (309) 624-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Associated University Neurosurgeons SC Neurological Surgery PastSince Jan 29, 2004 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

515 Valley View Dr
Moline, IL 61265

2200 Fort Jesse Rd
Normal, IL 61761
Phone (309) 268-9300

200 E Pennsylvania Ave
Peoria, IL 61603
Phone (309) 624-4000

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

719 N William Kumpf Blvd
Ste 100
Peoria, IL 61605
Phone (309) 624-9934

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 4

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.

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1437104593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E PENNSYLVANIA AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033089",
            "telephone_number": "309-624-4000",
            "fax_number": "309-624-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E PENNSYLVANIA AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033089",
            "telephone_number": "309-624-4000",
            "fax_number": "309-624-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JULIAN",
        "middle_name": "JWCHUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036108766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108766",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.