Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 125.078344 | IL |
Y | 208600000X | Surgeon | 125.078344 | IL |
NPI | 1013592104 |
---|---|
Provider Name | Timothy W Cho |
First Address | Indianapolis, IN 46229-5216 |
Second Address | Urbana, IL 61801-2529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2021 |
Last Update Date | 25/05/2021 |