MEDICARE: HAN KUCK LIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	036075698	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174633960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAN KUCK LIM MD

Provider Business Mailing Address
First Line	:	5140 N CALIFORNIA AVE
Second Line	:	SUITE 565
City	:	CHICAGO
State	:	IL
Zip	:	60625-2577
Country	:	US
Telephone Number	:	773-907-8700
Fax Number	:	773-907-8968

Provider Business Practice Location Address
First Line	:	5140 N CALIFORNIA AVE
Second Line	:	SUITE 565
City	:	CHICAGO
State	:	IL
Zip	:	60625-2577
Country	:	US
Telephone Number	:	773-907-8700
Fax Number	:	773-907-8968

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/25/2010

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Directions to “ HAN KUCK LIM MD” Practice Location

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