Koch Family Medicine Sc

LBN: Koch Family Medicine Sc
Koch Family Medicine Sc is an health care organization with primary practice located at 411 Maxine Dr , Morton IL 61550-2495. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Koch Family Medicine Sc can be contacted via phone (309) 263-2411, or through Koch, Stanley via phone (309) 263-2411.

Contact Information

Primary practice address
411 Maxine Dr Morton IL 61550-2495
Phone: (309) 263-2411
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Koch, Stanley Doctor of Medicine (MD)
Phone: (309) 263-2411

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1376665125
LBN Legal business name Koch Family Medicine Sc
DBA Doing business as
Authorized official Koch, Stanley Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 4th, 2007
Last updated Oct 20th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376665125 NPPES
Illinois MEDICAID 036060959
Illinois Other 1467436436

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