Healthcare Provider Details

I. General information

NPI: 1598577124
Provider Name (Legal Business Name): CS PACS 3 IL, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 N GREENWOOD AVE
PARK RIDGE IL
60068-2054
US

IV. Provider business mailing address

1643 NW 136TH AVENUE BLDG H, SUITE 100
SUNRISE FL
33323-2857
US

V. Phone/Fax

Practice location:
  • Phone: 847-692-5600
  • Fax:
Mailing address:
  • Phone: 865-500-1325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ELMER CHOI
Title or Position: OWNER/PRESIDENT/DIRECTOR
Credential: MD
Phone: 865-693-1000