Provider Demographics
NPI:1861593865
Name:MOON, CHO H (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:CHO
Middle Name:H
Last Name:MOON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2331 LEGENDS CT
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3856
Mailing Address - Country:US
Mailing Address - Phone:847-914-0518
Mailing Address - Fax:847-914-0518
Practice Address - Street 1:2331 LEGENDS COURT
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3856
Practice Address - Country:US
Practice Address - Phone:847-914-0518
Practice Address - Fax:847-914-0518
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist