MEDICARE: DR. JAE HYUNG LIM D.C.

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	111N00000X	Chiropractor		IL

General Provider Information

NPI Number	:	1598989188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAE HYUNG LIM D.C.

Provider Business Mailing Address
First Line	:	3534 MILWAUKEE AVE
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-7130
Country	:	US
Telephone Number	:	847-544-5060
Fax Number	:	847-544-5061

Provider Business Practice Location Address
First Line	:	3534 MILWAUKEE AVE
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-7130
Country	:	US
Telephone Number	:	847-544-5060
Fax Number	:	847-544-5061

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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