Tagle, Laura Koeppel
Tagle, Laura Koeppel is an individual health care provider with primary practice located at 2900 Foxfield Rd , St Charles IL 60174-5799. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Tagle, Laura Koeppel can be contacted via phone (630) 208-3200.Contact Information
Primary practice address
2900 Foxfield Rd
St Charles IL 60174-5799
Phone: (630) 208-3200
Fax: (630) 208-3201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2008-00673 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036138795 | Illinois |
Profile Details
| NPI number | 1053440008 |
|---|---|
| LBN Legal business name | Tagle, Laura Koeppel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 5th, 2007 |
| Last updated | Sep 16th, 2015 - about 11 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 | 1053440008 | NPPES |
| South Carolina | MEDICAID | N0067F | |
| South Carolina | MEDICAID | 1053440008 | |
| South Carolina | Other | 920540 | |
| South Carolina | MEDICAID | 5909695 | |
| South Carolina | Other | F400237969 |
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