Koeppe, Susan L

Koeppe, Susan L is an individual health care provider with primary practice located at 1051 W Us Route 6 Suite 100, Morris IL 60450-3349. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Koeppe, Susan L can be contacted via phone (815) 942-4875.

Contact Information

Primary practice address
1051 W Us Route 6 Suite 100 Morris IL 60450-3349
Phone: (815) 942-4875
Fax: (815) 942-5046
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209004405 Illinois

Profile Details

NPI number 1871502369
LBN Legal business name Koeppe, Susan L
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Jul 27th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871502369 NPPES
Illinois Other 0739010005 MEDICARE NSC
Illinois Other 0739010006 MEDICARE NSC
Illinois Other 0739010008 MEDICARE NSC
Illinois Other CL7476 MEDICARE NSC
Illinois Other P00294919 MEDICARE NSC
Illinois Other 0739010001 MEDICARE NSC
Illinois MEDICAID 209004405 MEDICARE NSC

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