Provider Demographics
NPI:1598989188
Name:LIM, JAE HYUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:JAE
Middle Name:HYUNG
Last Name:LIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3534 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-7130
Mailing Address - Country:US
Mailing Address - Phone:847-544-5060
Mailing Address - Fax:847-544-5061
Practice Address - Street 1:3534 MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-7130
Practice Address - Country:US
Practice Address - Phone:847-544-5060
Practice Address - Fax:847-544-5061
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor