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General NPI Number Information
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NPI Number | 1083358345
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Entity Type | Individual
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Provider Name | JAE YEON CHOI
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 1900 E GOLF RD
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City | SCHAUMBURG
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State | IL
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Zip | 60173-5834
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Country | US
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Telephone | 847-891-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 2127 SNOW CREEK RD
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City | NAPERVILLE
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State | IL
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Zip | 60564-4365
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Country | US
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Telephone | 929-528-2194
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.034481
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License Number State | IL
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