Provider Demographics
NPI:1114094042
Name:CHOO, JULIA JUNG (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:JUNG
Last Name:CHOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 W ERIE ST
Mailing Address - Street 2:#806
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-6456
Mailing Address - Country:US
Mailing Address - Phone:312-787-6825
Mailing Address - Fax:
Practice Address - Street 1:2000 OGDEN AVE
Practice Address - Street 2:RUSH COPLEY MEDICAL CENTER
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7222
Practice Address - Country:US
Practice Address - Phone:630-978-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA905392085R0001X
IL0361080072085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
04515143OtherBCBS PROVIDER
CA00A905390Medicaid
IL0727500001Medicare NSC
IL390362003Medicare PIN
04515143OtherBCBS PROVIDER
CA00A905390Medicaid