Provider Demographics
NPI:1689030793
Name:CHOE, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CHOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 N NORTHWEST HWY
Mailing Address - Street 2:APT B
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:224-628-7905
Mailing Address - Fax:
Practice Address - Street 1:401 S MILWAUKEE AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5070
Practice Address - Country:US
Practice Address - Phone:224-676-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.010909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor