1124170576 NPI number — PHILIP N CHOR MD

Table of content: PHILIP N CHOR MD (NPI 1124170576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124170576 NPI number — PHILIP N CHOR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOR
Provider First Name:
PHILIP
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124170576
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1725 W HARRISON STREET
Provider Second Line Business Mailing Address:
SUITE 964
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60612-3862
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-243-8277
Provider Business Mailing Address Fax Number:
312-243-7537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1725 W HARRISON STREET
Provider Second Line Business Practice Location Address:
SUITE 964
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612-3862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-243-8277
Provider Business Practice Location Address Fax Number:
312-243-7537
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4028483 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0021607841 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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