Individual provider Active NPI

Jennifer Lim-Dunham, MD

  • Pediatric Radiology Physician
  • Maywood, IL
National Provider Identifier
1487631354
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
36083294 Issued in IL
Practice address
2106 S First Ave
101 1740 Loyola University Medical Center
Maywood, IL 60153
Phone
(708) 216-9000
Fax
(708) 216-9033
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 36083294 IL Primary

Addresses

Primary practice location

2106 S First Ave
101 1740 Loyola University Medical Center
Maywood, IL 60153

Mailing address

2106 S First Ave
101 1740 Loyola University Medical Center
Maywood, IL 60153
Phone (708) 216-9000

Other identifiers 1

IdentifierTypeStateIssuer
36083294MedicaidIL

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
I20050803000055 IL Practitioner - Diagnostic Radiology 6204864945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Chicago, Pritzker School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008
  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054
  • Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101
  • Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36083294ILMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jan 1, 2009 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Jan 1, 2009 Accepting new patients

Locations

420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

Interoperability endpoints

  • Direct secure messaging: jlimdunham12597@direct.luhs.org

Organizations & group practices 3

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 6

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1487631354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 S FIRST AVE",
            "address_2": "101 1740 LOYOLA UNIVERSITY MEDICAL CENTER",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-9000",
            "fax_number": "708-216-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 S FIRST AVE",
            "address_2": "101 1740 LOYOLA UNIVERSITY MEDICAL CENTER",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-9000",
            "fax_number": "708-216-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM-DUNHAM",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IL",
            "license": "36083294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36083294",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.