Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036-056554 | IL |
N | 2080P0201X | Pediatric Allergist | 036-056554 | IL |
NPI | 1306915012 |
---|---|
Provider Name | Dr. Ming-Te M Lin |
First Address | Flossmoor, IL 60422 |
Second Address | Flossmoor, IL 60422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 10/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D13289 | (02) |