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Individual

DR. CHARLES E. KOESTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
101 TRANSCRAFT DR, ANNA, IL 62906-2114
(618) 833-2179
Mailing address
101 TRANSCRAFT DR, ANNA, IL 62906-2114
(618) 833-2179
(618) 833-4596

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.010812
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038010812
IL
01
215015
MEDICARE GROUP #
IL
01
K37019
MEDICARE PROVIDER #
IL
Enumeration date
11/22/2006
Last updated
11/19/2008
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