=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518191873
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAN K. LIM, M. D., S. C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2009
-----------------------------------------------------
Last Update Date | 05/14/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5140 N CALIFORNIA AVE SUITE 565
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60625-3645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-907-8700
-----------------------------------------------------
Fax | 773-907-8968
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5140 N CALIFORNIA AVE SUITE 565
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60625-3645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-907-8700
-----------------------------------------------------
Fax | 773-907-8968
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | HAN KUCK LIM
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 773-907-8700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------