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General NPI Number Information
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NPI Number | 1922073501
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Entity Type | Individual
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Provider Name | CHUNG S RIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 10350 HALIGUS RD STE 200
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City | HUNTLEY
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State | IL
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Zip | 60142
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Country | US
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Telephone | 815-338-6600
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Fax | 847-802-7203
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Provider Business Mailing Address
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Address Line | 10350 HALIGUS RD STE 200
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City | HUNTLEY
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State | IL
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Zip | 60142-9545
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Country | US
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Telephone | 815-338-6600
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Fax | 847-802-7203
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036083588
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036083588
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License Number State | IL
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