Organization
CHONG SOO RIM M-D LTD
Active
Other names
Chong S. Rim, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHONG SOO RIM M.D. (OWNER)
(773) 275-4446
Entity
Organization
Contact information
Practice address
5140 N CALIFORNIA AVE, SUITE 715, CHICAGO, IL 60625-3645
(773) 275-4446
Mailing address
5140 N CALIFORNIA AVE, SUITE 715, CHICAGO, IL 60625-3645
(773) 275-4446
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036046303
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046303
—
IL
01
—
212045
MEDICARE GROUP ID
—
01
—
21603473
BLUE SHIELD PROVIDER #
IL
01
—
36921508300
ADVOCATE LUTHERAN GROUP #
IL
01
—
5039
ADVOCATE LUTHERAN PIN #
IL
Enumeration date
11/02/2006
Last updated
03/16/2017
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