Provider Demographics
NPI:1508821778
Name:CHOH, JOONG H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOONG
Middle Name:H
Last Name:CHOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 N RANDALL RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2306
Mailing Address - Country:US
Mailing Address - Phone:847-695-1620
Mailing Address - Fax:847-695-1954
Practice Address - Street 1:1435 N RANDALL RD
Practice Address - Street 2:SUITE 209
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2306
Practice Address - Country:US
Practice Address - Phone:847-695-1620
Practice Address - Fax:847-695-1954
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060108208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060108Medicaid
IL036060108Medicaid
ILF400133332Medicare PIN
ILPO5451Medicare PIN
ILF400133330Medicare PIN