Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 036116832 | IL |
NPI | 1003035122 |
---|---|
Provider Name | Haemi Choi |
First Address | Bolingbrook, IL 60440-4955 |
Second Address | Hickory Hills, IL 60457-2238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 26/10/2020 |