MEDICARE: SANDRA CHO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209.026816	IL

General Provider Information

NPI Number	:	1073210563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA CHO

Provider Business Mailing Address
First Line	:	17 N STATE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3315
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 N STATE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3315
Country	:	US
Telephone Number	:	312-592-6800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2023
Last Update Date	:	02/17/2023

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Directions to “ SANDRA CHO ” Practice Location

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