Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 019031205 | IL |
NPI | 1164039947 |
---|---|
Provider Name | Yale Cho |
First Address | Chicago, IL 60661-1286 |
Second Address | Oakbrook Terrace, IL 60181-4454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2020 |
Last Update Date | 25/09/2020 |