Individual provider Active NPI

Johnny L. Lin, M.D.

  • Orthopaedic Foot and Ankle Surgery Physician
  • Chicago, IL
National Provider Identifier
1447206677
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
036115264 Issued in IL
Practice address
1611 W Harrison St # 400
Chicago, IL 60612-4861
Phone
(312) 243-4244
Fax
(312) 942-1517
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 036115264 IL Primary

Addresses

Primary practice location

1611 W Harrison St # 400
Chicago, IL 60612-4861

Mailing address

1 Westbrook Corporate Ctr
#240
Westchester, IL 60154-5701

Other identifiers 6

IdentifierTypeStateIssuer
036115264 1MedicaidIL
207067OtherILMEDICARE PTAN NUMBER LOCALITY #16
DA4902OtherILRR MEDICARE PTAN NUMBER
7686873OtherILAETNA
207073OtherILMEDICARE PTAN NUMBER LOCALITY #15
P00381332OtherILRR MEDICARE PROVIDER NUMBER

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
I20060606000308 IL Practitioner - Orthopedic Surgery 7719915073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rci (WRS) LLCGroup PAC ID 5092624510, shared by 17 NPIs, 325 clinicians
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1300 Lincolnway
Valparaiso, IN 46383-5824

1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036115264ILMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Jul 15, 2006 Accepting new patients
Orthomidwest, PLLC Current Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Jul 15, 2006 Accepting new patients
CC Bpci PLC Past Accepting new patients
Campbell Clinic, PC Foot and Ankle Surgery Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

1725 W Harrison St
Ste 1063
Chicago, IL 60612
Phone (312) 243-4244

963 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 725-8425

55 Shuman Blvd
Ste 700
Naperville, IL 60563
Phone (630) 339-2225

324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • Direct secure messaging: johnny.lin.1@12576.direct.athenahealth.com

Organizations & group practices 8

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 5

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1447206677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WESTBROOK CORPORATE CTR",
            "address_2": "#240",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST # 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-243-4244",
            "fax_number": "312-942-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JOHNNY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "IL",
            "license": "036115264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115264   1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN NUMBER LOCALITY #16",
            "identifier": "207067",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "DA4902",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7686873",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN NUMBER LOCALITY #15",
            "identifier": "207073",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER NUMBER",
            "identifier": "P00381332",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.