Individual provider Active NPI

Peter Lim, DO

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1316477995
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036151544 Issued in IL
Practice address
4753 N Elston Ave
Chicago, IL 60630-4490
Phone
(773) 205-7200
Fax
(773) 481-7577
NPI assigned
Jun 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036151544 IL Primary

Addresses

Primary practice location

4753 N Elston Ave
Chicago, IL 60630-4490

Mailing address

4753 N Elston Ave
Chicago, IL 60630-4490
Phone (773) 205-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address plim277112@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200709002638 IL Practitioner - Internal Medicine 5991128910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 2218a
Evanston, IL 60201-1700
Phone (847) 503-4222

Hospital & facility affiliations

  • Choice Home Health Services, Inc Home health agency, Chicago, IL, CCN 147972
  • Residential Home Health Home health agency, Northbrook, IL, CCN 147001
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc CurrentSince Aug 3, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 14, 2023 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Feb 14, 2023 Accepting new patients
Swedish Covenant Management Services, Inc. Internal Medicine Current Accepting new patients

Locations

5215 N California Ave
Ste 700
Chicago, IL 60625
Phone (847) 691-0404

9532 Eagle Way
Chicago, IL 60678

4753 N Elston Ave
Chicago, IL 60630
Phone (773) 205-7200

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5215 N California Ave
Ste F603
Chicago, IL 60625
Phone (773) 878-3627

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

Interoperability endpoints

  • Direct secure messaging: plim277112@direct.northshore.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1316477995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4753 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304490",
            "telephone_number": "773-205-7200",
            "fax_number": "773-481-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 N ELSTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304490",
            "telephone_number": "773-205-7200",
            "fax_number": "773-481-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "PETER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036151544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "plim277112@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5145 N California Ave",
            "address_2": "5145 N. California Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606256062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.