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General NPI Number Information
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NPI Number | 1578131967
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Entity Type | Individual
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Provider Name | MINJI CHON DMD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2021
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 2062 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-4002
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Country | US
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Telephone | 773-384-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 W SAPPHIRE DR
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60192-3814
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Country | US
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Telephone | 847-387-2041
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 319022459
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License Number State | IL
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