Individual provider Active NPI

Min H Lin, M.D.

  • Internal Medicine Physician
  • Round Lake, IL
National Provider Identifier
1902861289
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36045267 Issued in IL
Practice address
206 W. Nippersink Rd.
Round Lake, IL 60073
Phone
(847) 546-8500
Fax
(847) 546-4409
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36045267 IL Primary

Addresses

Primary practice location

206 W. Nippersink Rd.
Round Lake, IL 60073

Mailing address

206 W. Nippersink Rd.
Round Lake, IL 60073
Phone (847) 546-8500

Other identifiers 1

IdentifierTypeStateIssuer
36045267MedicaidIL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36045267ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Min H. Lin, M.D. LTD. CurrentSince Jul 22, 2008 Accepting new patients
Waukegan Clinic Corp Internal Medicine Past Accepting new patients

Locations

206 W Nippersink Rd
Round Lake, IL 60073
Phone (847) 546-8500

Interoperability endpoints

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1902861289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W. NIPPERSINK RD.",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "60073",
            "telephone_number": "847-546-8500",
            "fax_number": "847-546-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W. NIPPERSINK RD.",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "60073",
            "telephone_number": "847-546-8500",
            "fax_number": "847-546-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "MIN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36045267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36045267",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.