Koch, David
Koch, David is an individual health care provider with primary practice located at 2200 Fort Jesse Rd Suite 280, Normal IL 61761-6286. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Body Imaging is his primary health care specialty. Koch, David can be contacted via phone (309) 452-1788.Contact Information
Primary practice address
2200 Fort Jesse Rd Suite 280
Normal IL 61761-6286
Phone: (309) 452-1788
Fax: (309) 862-1302
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | Illinois | |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | Illinois |
Profile Details
| NPI number | 1063451789 |
|---|---|
| LBN Legal business name | Koch, David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063451789 | NPPES |
| Illinois | MEDICAID | 036069421*1 |
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