Organization
LIN PAIN CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EI SHUN LIN M.D. (PRESIDENT)
(618) 288-0879
Entity
Organization
Contact information
Practice address
16B PROFESSIONAL PARK DR, MARYVILLE, IL 62062-5672
(618) 288-0879
(618) 288-3351
Mailing address
MARYVILLE PROFESSIONAL PARK, 16B PROFESSIONAL PARK DRIVE, MARYVILLE, IL 62062
(618) 288-0879
(618) 288-3351
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036-055942
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055942
—
IL
Enumeration date
04/23/2007
Last updated
04/23/2013
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