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Individual

EDISON UY LIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1572 S BELL SCHOOL RD, CHERRY VALLEY, IL 61016-9362
(815) 332-3015
(815) 332-7805
Mailing address
1572 S BELL SCHOOL RD, CHERRY VALLEY, IL 61016-9362
(815) 332-3015
(815) 332-7805

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036090152
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036090152
IL
01
553180
MEDICARE GROUP #
IL
Enumeration date
07/03/2006
Last updated
09/05/2014
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