Active NPI
Jeffrey Lin, MD
- Neonatal-Perinatal Medicine Physician
- Blue Island, IL
National Provider Identifier
1710941638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 036052677
- Practice address
- 2320 High St
Blue Island, IL 60406-2426 - Phone
- (708) 388-5500
- Fax
- (708) 388-5672
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 036052677 | IL | Primary |
Addresses
Primary practice location
2320 High St
Blue Island, IL 60406-2426
Mailing address
2320 High St
Blue Island, IL 60406-2426
Phone (708) 388-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036052677 | Medicaid | IL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036052677 | IL | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1710941638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2320 HIGH ST",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604062426",
"telephone_number": "708-388-5500",
"fax_number": "708-388-5672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2320 HIGH ST",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604062426",
"telephone_number": "708-388-5500",
"fax_number": "708-388-5672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "JEFFREY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-17",
"last_updated": "2010-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IL",
"license": "036052677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036052677",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blue Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.