MEDICARE: MRS. JOONGSIK Y CHO MD

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	208000000X	Pediatrics Physician		IL

General Provider Information

NPI Number	:	1992776751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOONGSIK Y CHO MD

Provider Business Mailing Address
First Line	:	404 LIBERTY ST
Second Line	:
City	:	MORRIS
State	:	IL
Zip	:	60450-2133
Country	:	US
Telephone Number	:	815-942-6116
Fax Number	:	815-942-5927

Provider Business Practice Location Address
First Line	:	404 LIBERTY ST
Second Line	:
City	:	MORRIS
State	:	IL
Zip	:	60450-2133
Country	:	US
Telephone Number	:	815-942-6116
Fax Number	:	815-942-5927

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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