Basic Information
| Provider Information | |||||||||
| NPI: | 1093978538 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHON | ||||||||
| FirstName: | ANDY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2357 SEQUOIA DR | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605066222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308598700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1221 N HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605061404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308598700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2008 | ||||||||
| LastUpdateDate: | 07/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125054338 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2012-00149 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2085R0202X | 2012-00149 | NC | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 262075 | MA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 036139673 | IL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.