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General NPI Number Information
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NPI Number | 1649911744
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Entity Type | Individual
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Provider Name | YOUNG-IN CHOI
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Gender | Male
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 400 MAPLE SUMMIT RD
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City | JERSEYVILLE
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State | IL
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Zip | 62052-2028
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Country | US
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Telephone | 618-498-6402
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Fax |
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Provider Business Mailing Address
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Address Line | 27100 CHARDON RD
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-1116
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Country | US
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Telephone | 440-516-8704
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Fax | 216-201-6737
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016006135
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License Number State | IL
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