Provider Demographics
NPI:1164039947
Name:CHO, YALE (DMD)
Entity type:Individual
Prefix:
First Name:YALE
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N JEFFERSON ST APT 2407
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1286
Mailing Address - Country:US
Mailing Address - Phone:847-769-1336
Mailing Address - Fax:
Practice Address - Street 1:17W110 22ND ST STE 150
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4454
Practice Address - Country:US
Practice Address - Phone:847-769-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190312051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty