MEDICARE: DR. JAMES PETER CHOCA PH.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	103G00000X	Clinical Neuropsychologist	IL
2	103TC0700X	Clinical Psychologist	IL
3	103T00000X	Psychologist	IL
4	103TF0200X	Forensic Psychologist	IL
5	103TM1800X	Intellectual & Developmental Disabilities Psychologist	IL

General Provider Information

NPI Number	:	1497820377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PETER CHOCA PH.D.

Provider Business Mailing Address
First Line	:	2116 N SEDGWICK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4620
Country	:	US
Telephone Number	:	773-472-7791
Fax Number	:	773-472-7791

Provider Business Practice Location Address
First Line	:	2116 N SEDGWICK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-4620
Country	:	US
Telephone Number	:	773-472-7791
Fax Number	:	773-472-7791

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

Provider Enumeration Date	:	11/23/2006
Last Update Date	:	09/11/2025

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