Individual
KENNETH LEE CHOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01063644A
IN
207RN0300X
Nephrology Physician
036111704
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000536207
ANTHEM BCBS
IN
01
—
100082060
MEDICAID GROUP
IN
05
—
200876580
—
IN
01
—
628850
MEDICARE GROUP
IN
Enumeration date
04/02/2007
Last updated
04/29/2025
Update your record
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