Healthcare Provider Details

I. General information

NPI: 1013440221
Provider Name (Legal Business Name): ALEXANDER JAEHYUK CHOI M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 N SAINT CLAIR ST STE 7-701
CHICAGO IL
60611-2927
US

IV. Provider business mailing address

676 N SAINT CLAIR ST STE 7-701
CHICAGO IL
60611-2927
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-7950
  • Fax: 312-926-4771
Mailing address:
  • Phone: 312-695-7950
  • Fax: 312-926-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101268531
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036153157
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number036153157
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number036153157
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: