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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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 1063451789 NPPES
Illinois MEDICAID 036069421*1

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