Provider Demographics
NPI:1164608881
Name:ROSA HAE S. CHOI M.D., S.C.
Entity Type:Organization
Organization Name:ROSA HAE S. CHOI M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:WISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-383-3010
Mailing Address - Street 1:6853 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1023
Mailing Address - Country:US
Mailing Address - Phone:708-383-3010
Mailing Address - Fax:
Practice Address - Street 1:6853 NORTH AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1023
Practice Address - Country:US
Practice Address - Phone:708-383-3010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty