Individual provider · Type 1 NPI
Ethan Jin, DO
Addiction Medicine (Anesthesiology) Physician · Maywood, IL
NPI number
1942051719
Active
Practice location
2160 S 1st Ave
Maywood, IL 60153-3328
Mailing address
4145 Winterberry Rd
Cumming, GA 30040-6167
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Addiction Medicine (Anesthesiology) Physician Primary | 207LA0401X | 125.084194 (IL) |
Addiction Medicine (Anesthesiology) Physician: An anesthesiologist who specializes in the diagnosis and treatment of addictions.
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About NPI 1942051719
Ethan Jin, DO's National Provider Identifier is 1942051719, issued on Mar 29, 2024. The primary taxonomy on file is Addiction Medicine (Anesthesiology) Physician (207LA0401X), and the practice location is in Maywood, IL. The record was last updated on Aug 13, 2024.