Healthcare Provider Details

I. General information

NPI: 1649385881
Provider Name (Legal Business Name): AI HUA KEH-LIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5TH AVENUE & ROOSEVELT ROAD
HINES IL
60141
US

IV. Provider business mailing address

11 BRIGHTON LN
OAK BROOK IL
60523-2323
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-2169
  • Fax:
Mailing address:
  • Phone: 630-571-4588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: