Provider Demographics
NPI:1730336835
Name:D.C.LIM.MD INC.
Entity type:Organization
Organization Name:D.C.LIM.MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DINNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-463-5412
Mailing Address - Street 1:230 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-2282
Mailing Address - Country:US
Mailing Address - Phone:217-463-5412
Mailing Address - Fax:217-466-6994
Practice Address - Street 1:230 S HIGH ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-2282
Practice Address - Country:US
Practice Address - Phone:217-463-5412
Practice Address - Fax:217-466-6994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036088371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036088371Medicaid
IL02322401OtherBLUE CROSS/BLUE SHIELD
INM100021816Medicare PIN
IL02322401OtherBLUE CROSS/BLUE SHIELD
080116487Medicare PIN
IL435600Medicare PIN
F85723Medicare UPIN