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NPI Code Detail

MEDICARE: REBECCA A. LIM M.D.

MEDICARE: REBECCA A. LIM M.D.
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
1207L00000XAnesthesiology Physician036046220IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821090606
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA A. LIM M.D.
Provider Business Mailing Address
First Line : 3998 FAIR RIDGE RD
Second Line : SUITE 300
City : FAIRFAX
State : VA
Zip : 22033-2921
Country : US
Telephone Number : 703-293-9592
Fax Number : 703-766-9725
Provider Business Practice Location Address
First Line : 1225 W LAKE ST
Second Line : WESTLAKE HOSPITAL / ANESTHESIA DEPARTMENT
City : MELROSE PARK
State : IL
Zip : 60160-4039
Country : US
Telephone Number : 708-681-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 03/24/2015

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