Active NPI
Im Suk Choi, M.D.
- Anesthesiology Physician
- Rock Island, IL
National Provider Identifier
1730189994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Practice address
- 2701 17TH St
Rock Island, IL 61201-5351 - Phone
- (309) 779-5000
- NPI assigned
- Jul 28, 2005
- Reactivated
- Mar 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | IL | Primary |
Addresses
Primary practice location
2701 17TH St
Rock Island, IL 61201-5351
Mailing address
PO Box 689
Lake Forest, IL 60045-0689
Phone (800) 444-6110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0537928 | Medicaid | IA |
Other names 1
- Im Suk Choi
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036048943 | IL | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1730189994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 689",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600450689",
"telephone_number": "800-444-6110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 17TH ST",
"city": "ROCK ISLAND",
"state": "IL",
"postal_code": "612015351",
"telephone_number": "309-779-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOI",
"first_name": "IM",
"middle_name": "SUK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-28",
"last_updated": "2007-10-10",
"deactivation_date": "2006-03-22",
"reactivation_date": "2006-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0537928",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "IM",
"last_name": "CHOI",
"middle_name": "SUK",
"credential": "M.D. S.C.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Rock Island, 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.