Individual
CRAIG D KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-7257
Mailing address
10948 LOCUST RD, TREMONT, IL 61568-9015
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125064826
IL
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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