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Individual

ANDREW KOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
1276 N CLYBOURN AVE, CHICAGO, IL 60610
(312) 337-1073
Mailing address
1948 N HUMBOLDT BLVD APT 310, CHICAGO, IL 60647-3828

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209017980
IL

Other

Enumeration date
08/29/2018
Last updated
09/04/2018
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