Provider Demographics
NPI:1841565694
Name:CHRIS OH, M.D., S.C.
Entity Type:Organization
Organization Name:CHRIS OH, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KYONG
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-375-8181
Mailing Address - Street 1:3633 W LAKE AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5804
Mailing Address - Country:US
Mailing Address - Phone:847-375-8181
Mailing Address - Fax:
Practice Address - Street 1:3633 W LAKE AVE STE 410
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5804
Practice Address - Country:US
Practice Address - Phone:847-375-8181
Practice Address - Fax:847-375-8310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI01924Medicare UPIN