Provider Demographics
NPI:1144309436
Name:SUH, JINHWA LEE (DC)
Entity type:Individual
Prefix:DR
First Name:JINHWA
Middle Name:LEE
Last Name:SUH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 W HIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-3714
Mailing Address - Country:US
Mailing Address - Phone:947-843-8664
Mailing Address - Fax:847-843-8118
Practice Address - Street 1:142 W HIGGINS RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-3714
Practice Address - Country:US
Practice Address - Phone:947-843-8664
Practice Address - Fax:847-843-8118
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007191111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL319630Medicare ID - Type Unspecified
ILU38531Medicare UPIN