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General NPI Number Information
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NPI Number | 1811082886
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Entity Type | Individual
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Provider Name | SEONG R CHO MD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1001 HEALTH CENTER DR
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City | MATTOON
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State | IL
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Zip | 61938-4693
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Country | US
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Telephone | 217-258-2250
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Fax | 217-258-2249
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Provider Business Mailing Address
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Address Line | 210 W MCKINLEY AVE STE 1
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City | DECATUR
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State | IL
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Zip | 92526
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Country | US
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Telephone | 217-876-6600
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Fax | 217-876-6606
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 036112160
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036112160
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License Number State | IL
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