Provider Demographics
NPI:1811371099
Name:CHOI, JUN HYEOK (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUN HYEOK
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 THEODORE ST
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-1881
Mailing Address - Country:US
Mailing Address - Phone:815-741-1700
Mailing Address - Fax:
Practice Address - Street 1:2241 THEODORE ST
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-1881
Practice Address - Country:US
Practice Address - Phone:815-741-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190303071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice