MEDICARE: ALBERT F CHOI O.D.

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	152W00000X	Optometrist	046010089	IL

General Provider Information

NPI Number	:	1720238058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT F CHOI O.D.

Provider Business Mailing Address
First Line	:	1298 FOX VALLEY CTR
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-4184
Country	:	US
Telephone Number	:	630-851-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3760 N BROADWAY ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-4105
Country	:	US
Telephone Number	:	773-975-2020
Fax Number	:	773-975-2085

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

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	06/04/2019

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