Healthcare Provider Details

I. General information

NPI: 1285563064
Provider Name (Legal Business Name): WARREN LIM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N CLARK ST FL 6
CHICAGO IL
60654-4712
US

IV. Provider business mailing address

20000 N 57TH AVE RM P205
GLENDALE AZ
85308-7210
US

V. Phone/Fax

Practice location:
  • Phone: 312-274-4520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: