Provider Demographics
NPI:1548762339
Name:XIN, JOHN JUNPING
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JUNPING
Last Name:XIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JUNPING
Other - Middle Name:
Other - Last Name:XIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5841 SOUTH MARYLAND AVENUE
Mailing Address - Street 2:RM. TW-020A, MC0006
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-2922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program