1871026724 NPI number — BO YEON CHOI DMD

Table of content: BO YEON CHOI DMD (NPI 1871026724)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871026724 NPI number — BO YEON CHOI DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOI
Provider First Name:
BO YEON
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

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:
1871026724
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39W660 NORTON LAKE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT CHARLES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60175-8482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-241-0475
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2505 W SCHAUMBURG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHAUMBURG
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60194-3887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-818-8266
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/07/2017

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: 1223G0001X , with the licence number:  019.031238 , 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)