Provider Demographics
NPI:1124170576
Name:CHOR, PHILIP N (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:N
Last Name:CHOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W HARRISON STREET
Mailing Address - Street 2:SUITE 964
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3862
Mailing Address - Country:US
Mailing Address - Phone:312-243-8277
Mailing Address - Fax:312-243-7537
Practice Address - Street 1:1725 W HARRISON STREET
Practice Address - Street 2:SUITE 964
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3862
Practice Address - Country:US
Practice Address - Phone:312-243-8277
Practice Address - Fax:312-243-7537
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
4028483OtherAETNA
IL0021607841OtherBLUE CROSS BLUE SHIELD
IL0021607841OtherBLUE CROSS BLUE SHIELD
484840Medicare ID - Type Unspecified