Individual
JUSTIN KOEHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
555 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3306
(847) 690-1776
(847) 690-1777
Mailing address
555 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3306
(847) 690-1776
(847) 690-1777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IL
Other
Enumeration date
11/06/2017
Last updated
12/07/2021
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