Individual
MRS. SUSAN HATFIELD KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUSAN KOCH M.D.
Contact information
Practice address
456 FRONTAGE RD, SUITE 28, NORTHFIELD, IL 60093-3034
(847) 707-2600
Mailing address
456 FRONTAGE RD, SUITE 28, NORTHFIELD, IL 60093-3034
(847) 707-2600
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
336052360
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036090747
IL
Other
Enumeration date
12/27/2009
Last updated
12/27/2009
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