Provider Demographics
NPI:1316275258
Name:CHOI, YOUNG
Entity type:Individual
Prefix:MR
First Name:YOUNG
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 N MILWAUKEE AVE
Mailing Address - Street 2:#119
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1888
Mailing Address - Country:US
Mailing Address - Phone:847-966-1900
Mailing Address - Fax:847-581-1300
Practice Address - Street 1:8901 N MILWAUKEE AVE
Practice Address - Street 2:#119
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1888
Practice Address - Country:US
Practice Address - Phone:847-966-1900
Practice Address - Fax:847-581-1300
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL142680156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician