MEDICARE: JENIFFER ELIZABETH LIMA 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	207Q00000X	Family Medicine Physician	036171114	IL

General Provider Information

NPI Number	:	1619590601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENIFFER ELIZABETH LIMA MD

Provider Business Mailing Address
First Line	:	450 E WATERSIDE DR UNIT 801
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-4709
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2834 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-7401
Country	:	US
Telephone Number	:	773-772-1139
Fax Number	:

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

Provider Enumeration Date	:	05/25/2020
Last Update Date	:	10/22/2024

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