Individual provider Active NPI

Changryol Choi, ATC

  • Specialist
  • Carlinville, IL
National Provider Identifier
1083722235
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
700 College Ave
Carlinville, IL 62626-1454
Phone
(800) 233-3550
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

700 College Ave
Carlinville, IL 62626-1454

Mailing address

345 Johnson St
Apt a-5
Carlinville, IL 62626-1470
Phone (800) 233-3550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
096.002340ILMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1083722235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 JOHNSON ST",
            "address_2": "APT A-5",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261470",
            "telephone_number": "800-233-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 COLLEGE AVE",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261454",
            "telephone_number": "800-233-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "CHANGRYOL",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlinville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.