Provider Demographics
NPI:1346335783
Name:WIN, PATRICK HTAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:HTAIN
Last Name:WIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:325 TAMARACK LN
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62269-2993
Mailing Address - Country:US
Mailing Address - Phone:618-624-2060
Mailing Address - Fax:
Practice Address - Street 1:325 TAMARACK LN
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62269-2993
Practice Address - Country:US
Practice Address - Phone:618-624-2060
Practice Address - Fax:618-624-2226
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005001335207K00000X, 207RA0201X
IL36117560207K00000X, 207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology