Individual
MELISSA BETH KOEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1801 W TAYLOR ST, CHICAGO, IL 60612-4319
(312) 355-4394
(312) 996-8739
Mailing address
525 N ADA ST APT 10, CHICAGO, IL 60622-6486
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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