Individual
DR. JAMES DAVID KOEPSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2829 GLENWOOD AVE, ROCKFORD, IL 61101-3542
(815) 962-0633
(815) 962-0142
Mailing address
2829 GLENWOOD AVE, ROCKFORD, IL 61101-3542
(815) 963-0633
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036077059
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077059
—
IL
Enumeration date
06/10/2006
Last updated
08/31/2010
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