Koepsell, James David
Koepsell, James David is an sole proprietor health care provider with primary practice located at 2829 Glenwood Ave , Rockford IL 61101-3542. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Koepsell, James David can be contacted via phone (815) 962-0633.Contact Information
Primary practice address
2829 Glenwood Ave
Rockford IL 61101-3542
Phone: (815) 962-0633
Fax: (815) 962-0142
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 036077059 | Illinois |
Profile Details
NPI number | 1285675967 |
---|---|
LBN Legal business name | Koepsell, James David |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 10th, 2006 |
Last updated | Aug 31st, 2010 - about 14 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 | 1285675967 | NPPES |
Illinois | MEDICAID | 036077059 |
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