NPIMap

Organization Active NPI

Grace Medical Center, SC

  • Exclusive Provider Organization
  • Lake in the Hills, IL
National Provider Identifier
1457405300
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
036083588 Issued in IL
Legal business name
GRACE MEDICAL CENTER, SC
Practice address
2250 W Algonquin Rd
Suite 112
Lake in the Hills, IL 60156-1289
Phone
(847) 854-5533
NPI assigned
Jan 22, 2007
Last updated
Nov 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Dr. Chung S Rim, M.D.
Title
Provider
Phone
(847) 854-5533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 036083588 IL Primary

Addresses

Primary practice location

2250 W Algonquin Rd
Suite 112
Lake in the Hills, IL 60156-1289

Mailing address

2250 W Algonquin Rd
Suite 112
Lake in the Hills, IL 60156-1289
Phone (847) 854-5533

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1457405300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 W ALGONQUIN RD",
            "address_2": "SUITE 112",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561289",
            "telephone_number": "847-854-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 W ALGONQUIN RD",
            "address_2": "SUITE 112",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561289",
            "telephone_number": "847-854-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL CENTER, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "RIM",
        "authorized_official_first_name": "CHUNG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "847-854-5533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "036083588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.