# GRACE MEDICAL CENTER, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457405300
- **Authorized official:** DR. CHUNG S RIM M.D. (PROVIDER)
- **Authorized official phone:** (847) 854-5533

## Contact information

- **Practice address:** 2250 W ALGONQUIN RD, SUITE 112, LAKE IN THE HILLS, IL 60156-1289
- **Practice address phone:** (847) 854-5533
- **Mailing address:** 2250 W ALGONQUIN RD, SUITE 112, LAKE IN THE HILLS, IL 60156-1289
- **Mailing address phone:** (847) 854-5533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 036083588 | IL | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 11/17/2011