Provider Demographics
NPI:1992776751
Name:CHO, JOONGSIK Y (MD)
Entity type:Individual
Prefix:MRS
First Name:JOONGSIK
Middle Name:Y
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:404 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-2133
Mailing Address - Country:US
Mailing Address - Phone:815-942-6116
Mailing Address - Fax:815-942-5927
Practice Address - Street 1:404 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-2133
Practice Address - Country:US
Practice Address - Phone:815-942-6116
Practice Address - Fax:815-942-5927
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics