Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 071005499 | IL |
N | 103TC0700X | Clinical Psychologist | 071005499 | IL |
N | 103G00000X | Clinical Psychologist | 071005499 | IL |
N | 103TC0700X | Clinical Psychologist | 071005499 | IL |
Y | 103TR0400X | Rehabilitation Psychologist | 071005499 | IL |
NPI | 1144331075 |
---|---|
Provider Name | Dr. Patricia Jo Lim |
First Address | Chicago, IL 60641-1664 |
Second Address | Chicago, IL 60612-3728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 10/09/2008 |