MEDICARE: DR. RICHARD DENNIS LIM 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	207XS0117X	Orthopaedic Surgery of the Spine Physician	036-091908	IL
2	207X00000X	Orthopaedic Surgery Physician	036-091908	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CL4152	OTHER	IL	RAILROAD MEDICARE PROVIDER NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036-091908	OTHER	IL	BLUE CROSS BLUE SHIELD PROVIDER NUMBER

General Provider Information

NPI Number	:	1134174352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DENNIS LIM MD

Provider Business Mailing Address
First Line	:	75 REMITTANCE DR
Second Line	:	SUITE 6581
City	:	CHICAGO
State	:	IL
Zip	:	60675-6581
Country	:	US
Telephone Number	:	708-226-3300
Fax Number	:	708-226-4202

Provider Business Practice Location Address
First Line	:	10719 WEST 160TH STREET
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-5541
Country	:	US
Telephone Number	:	708-226-3300
Fax Number	:	708-226-4202

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	12/21/2021

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Directions to “ DR. RICHARD DENNIS LIM MD” Practice Location

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