MEDICARE: DR. JEFFREY T CHOH M.D.

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	2471C3402X	Radiography Radiologic Technologist
2	174400000X	Specialist	036095510	IL
3	2085R0204X	Vascular & Interventional Radiology Physician	036.095510	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588641104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY T CHOH M.D.

Provider Business Mailing Address
First Line	:	2520 ELISHA AVENUE
Second Line	:
City	:	ZION
State	:	IL
Zip	:	60099
Country	:	US
Telephone Number	:	847-872-6259
Fax Number	:	847-872-5716

Provider Business Practice Location Address
First Line	:	2361 PAYSPHERE CIRCLE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674
Country	:	US
Telephone Number	:	847-746-4358
Fax Number	:

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

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	03/06/2015

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