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Individual

DR. CHONG SOO RIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5140 N CALIFORNIA AVE, SUITE 740, CHICAGO, IL 60625-3645
(773) 275-4446
Mailing address
5140 N CALIFORNIA AVE, SUITE 740, CHICAGO, IL 60625-3645
(773) 275-4446

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21603473
BLUE SHIELD PROVIDER #
IL
01
36921508300
ADVOCATE LUTHERAN NUMBER
IL
01
5039
ADVOCATE LUTHERAN PIN
IL
Enumeration date
11/02/2006
Last updated
07/09/2007
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