Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Jin, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1942051719

Ethan Jin, DO is a Student in an Organized Health Care Education/Training Program in Maywood, Illinois. Licensed in Illinois. Registered with an NPI since 2024.

Licensed in
IL
In the registry since
2024
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (708) 216-9169
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Anesthesiology) Physician (primary) Taxonomy 207LA0401X · Licence 125.084194 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1942051719
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 29, 2024
Last updated in NPPESAugust 13, 2024
Certification dateAugust 13, 2024
Mailing address4145 Winterberry Rd, Cumming, GA 30040-6167

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