Individual
VERNON KOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 E. ORANGE ST., HOOPESTON, IL 60942-1801
(217) 283-5531
(217) 283-7981
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
36066112
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620446
BLUE CROSS
IL
05
—
0360661121
—
IL
01
—
930105285
RRMCR
IL
Enumeration date
06/01/2006
Last updated
04/23/2015
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