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NPI Code Detail

MEDICARE: MARK CHOI DO

MEDICARE: MARK CHOI DO
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
12085R0202XDiagnostic Radiology Physician02002962IN
22085R0202XDiagnostic Radiology Physician46602-021WI
32085R0202XDiagnostic Radiology PhysicianDO1391NV
42085R0202XDiagnostic Radiology Physician34.009265OH
52085R0202XDiagnostic Radiology PhysicianIL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00455855OTHERILMEDICARE RAILROAD

General Provider Information

NPI Number : 1982690830
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK CHOI DO
Provider Business Mailing Address
First Line : 3249 OAK PARK AVE
Second Line : METROPOLITAN ADVANCED RADIOLOGICAL SERVICES, LTD
City : BERWYN
State : IL
Zip : 60402-3429
Country : US
Telephone Number : 708-783-2696
Fax Number : 708-783-3164
Provider Business Practice Location Address
First Line : 3249 OAK PARK AVE
Second Line : METROPOLITAN ADVANCED RADIOLOGICAL SERVICES, LTD
City : BERWYN
State : IL
Zip : 60402-3429
Country : US
Telephone Number : 708-783-2696
Fax Number : 708-783-3164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 04/16/2008

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