Provider Demographics
NPI:1750538880
Name:LINN, JOHN GRIFFITH (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:GRIFFITH
Last Name:LINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 PFINGSTEN RD STE 128
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1324
Mailing Address - Country:US
Mailing Address - Phone:847-570-1700
Mailing Address - Fax:847-733-5293
Practice Address - Street 1:2050 PFINGSTEN RD STE 128
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026
Practice Address - Country:US
Practice Address - Phone:847-570-1700
Practice Address - Fax:847-733-5293
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036127792208600000X
IL125-049136208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3050933Medicaid
OHLI4290271Medicare PIN