NPIMap

Organization Active NPI

Soon Ja Choi, MD

  • Primary Care Clinic/Center
  • Warrenville, IL
National Provider Identifier
1861773095
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036049941 Issued in IL
Legal business name
SOON JA CHOI, MD
Practice address
2S631 State Route 59
Warrenville, IL 60555-1441
Phone
(630) 393-3400
Fax
(630) 393-7589
NPI assigned
Sep 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Authorized official

Name
Soon Ja Choi Kim
Title
President
Phone
(630) 393-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036049941 IL Primary

Addresses

Primary practice location

2S631 State Route 59
Warrenville, IL 60555-1441

Mailing address

2S631 State Route 59
Warrenville, IL 60555-1441
Phone (630) 393-3400

Other identifiers 1

IdentifierTypeStateIssuer
036049941MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1861773095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2S631 STATE ROUTE 59",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605551441",
            "telephone_number": "630-393-3400",
            "fax_number": "630-393-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2S631 STATE ROUTE 59",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605551441",
            "telephone_number": "630-393-3400",
            "fax_number": "630-393-7589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOON JA CHOI, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "CHOI KIM",
        "authorized_official_first_name": "SOON JA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-393-3400"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036049941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049941",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.