Basic Information
Provider Information
NPI: 1427364835
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHOI
FirstName: ANN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: JEE
OtherFirstName: ANN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: DPT
OtherLastNameType: 1
Mailing Information
Address1: 790 REMINGTON BLVD
Address2:  
City: BOLINGBROOK
State: IL
PostalCode: 604404909
CountryCode: US
TelephoneNumber: 6302962223
FaxNumber: 6307599510
Practice Location
Address1: 841 S RANDALL RD
Address2:  
City: ELGIN
State: IL
PostalCode: 601233002
CountryCode: US
TelephoneNumber: 2248564448
FaxNumber: 8476080974
Other Information
ProviderEnumerationDate: 08/23/2010
LastUpdateDate: 06/08/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X070-018056ILY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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