Basic Information
| Provider Information | |||||||||
| NPI: | 1477052090 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHOE | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2060 RIVER OAKS DR | ||||||||
| Address2: | |||||||||
| City: | CALUMET CITY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604095074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7088912004 | ||||||||
| FaxNumber: | 7088912732 | ||||||||
| Practice Location | |||||||||
| Address1: | 2060 RIVER OAKS DR | ||||||||
| Address2: | |||||||||
| City: | CALUMET CITY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604095074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7088912004 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2018 | ||||||||
| LastUpdateDate: | 02/26/2018 | ||||||||
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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 | 152W00000X | 046011162 | IL | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.