Healthcare Provider Details

I. General information

NPI: 1063907947
Provider Name (Legal Business Name): JAMES CHOI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2018
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 N WALL ST STE P410
KANKAKEE IL
60901-3491
US

IV. Provider business mailing address

375 N WALL ST STE P410
KANKAKEE IL
60901-3491
US

V. Phone/Fax

Practice location:
  • Phone: 815-933-3814
  • Fax:
Mailing address:
  • Phone: 815-933-3814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036173244
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101023867
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: