Provider Demographics
NPI:1215249784
Name:LIN, WINLYNN A (MED)
Entity type:Individual
Prefix:
First Name:WINLYNN
Middle Name:A
Last Name:LIN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14953 S VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-5804
Mailing Address - Country:US
Mailing Address - Phone:815-609-1544
Mailing Address - Fax:815-609-1670
Practice Address - Street 1:14953 S VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5804
Practice Address - Country:US
Practice Address - Phone:815-609-1544
Practice Address - Fax:815-609-1670
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional