Monica J Koch, CCC/SLP
Individual provider Active NPI Speech-Language Pathologist · Breese, IL
NPI 1023534872 · NPPES record last updated Aug 14, 2017
Key facts
- NPI
- 1023534872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.007936 (IL)
- Practice address
- 777 Memorial Dr
Breese, IL 62230-1376 - Phone
- (618) 526-7128
- NPI assigned
- Aug 14, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.007936 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.007936 | IL | Yes |
Addresses
Primary practice location
777 Memorial Dr
Breese, IL 62230-1376
Mailing address
6535 Monterey Rd
Germantown, IL 62245-2503
Phone (618) 792-6529
Other providers in Breese, IL
- Alyssa M Kampwerth
- David Louis Kee
- Renee Keller
- Jennifer Jo Klostermann
- Katy Marie Knolhoff
- Megan Lynn Koehler
- Leslie Kohnen
- Amanda Nichole Korte
- Breck D Kramper
- Amy Kathleen Krause
All providers in Breese, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.