Provider Demographics
NPI:1336204031
Name:LIN, ANDY C (MD)
Entity type:Individual
Prefix:DR
First Name:ANDY
Middle Name:C
Last Name:LIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:71 W 156TH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-4260
Mailing Address - Country:US
Mailing Address - Phone:708-331-2200
Mailing Address - Fax:708-331-8015
Practice Address - Street 1:71 W 156TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-4260
Practice Address - Country:US
Practice Address - Phone:708-331-2200
Practice Address - Fax:708-331-8015
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2010-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY240534207RC0000X
IL036.126027207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease