Provider Demographics
NPI:1447481379
Name:LYN, WHITNEY NICOLE (MD)
Entity type:Individual
Prefix:MISS
First Name:WHITNEY
Middle Name:NICOLE
Last Name:LYN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3525 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-1019
Mailing Address - Country:US
Mailing Address - Phone:312-945-4040
Mailing Address - Fax:312-945-4088
Practice Address - Street 1:3525 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-1019
Practice Address - Country:US
Practice Address - Phone:312-945-4040
Practice Address - Fax:312-945-4088
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-129339207Q00000X
IL125.056452207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine