Individual
MR. JEREMIAH L LOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115
(815) 756-1521
(815) 748-8395
Mailing address
1 KISH HOSPITAL DR., DEKALB, IL 60115-9602
(815) 756-1521
(815) 748-8395
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
041.128750
IL
207L00000X
Anesthesiology Physician
209.000126
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
041-128750
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
209-000126
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
041128750
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332364034001
—
IL
Enumeration date
08/10/2005
Last updated
08/27/2018
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