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Individual

DR. DARREN EUGENE KOENIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-4201
(312) 949-7751
Mailing address
3241 S MICHIGAN AVE, CHICAGO, IL 60616-4201
(312) 949-7751
(713) 743-0963

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0460112373
IL
152W00000X
Optometrist
5413T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
178403501
TX
Enumeration date
04/13/2006
Last updated
01/10/2019
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