Provider Demographics
NPI:1184893091
Name:CHOI, JANE C
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:C
Last Name:CHOI
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 1:806 CIVIC CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3207
Mailing Address - Country:US
Mailing Address - Phone:847-965-3715
Mailing Address - Fax:847-965-3720
Practice Address - Street 1:806 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3207
Practice Address - Country:US
Practice Address - Phone:847-965-3715
Practice Address - Fax:847-965-3720
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician