MEDICARE: SUNG YONG CHOI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	198-000576	IL

General Provider Information

NPI Number	:	1073704573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNG YONG CHOI

Provider Business Mailing Address
First Line	:	825 CHICAGO AVE
Second Line	:	A
City	:	EVANSTON
State	:	IL
Zip	:	60202-2375
Country	:	US
Telephone Number	:	847-560-0095
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 CHICAGO AVE
Second Line	:	A
City	:	EVANSTON
State	:	IL
Zip	:	60202-2375
Country	:	US
Telephone Number	:	847-560-0095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	11/24/2014

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