Individual
THOMAS MICHAEL KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 878-8700
Mailing address
1242 N BOSWORTH AVE APT 1F, CHICAGO, IL 60642-3356
(847) 276-6425
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.010261
IL
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
01/15/2024
Last updated
03/06/2026
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