Individual provider Active NPI

Hannah Koh, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1073838249
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
125056446 Issued in IL
Practice address
1411 W Chicago Ave Apt 3
Chicago, IL 60642-7983
Phone
(312) 608-4006
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 125056446 IL Primary

Addresses

Primary practice location

1411 W Chicago Ave Apt 3
Chicago, IL 60642-7983

Mailing address

1411 W Chicago Ave Apt 3
Chicago, IL 60642-7983
Phone (312) 608-4006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260413002120 IL Practitioner - Diagnostic Radiology 6709005416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians

Practice addresses (Care Compare)

16901 63Rd St
Sherrard, IL 61281-8008
Phone (219) 767-6320

Hospital & facility affiliations

  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015
  • Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023
  • Franciscan Health Munster Hospital, Munster, IN, CCN 150165
  • Franciscan Health Lafayette Hospital, Lafayette, IN, CCN 150109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
131341CAMDClinical Social Worker
125056446ILMDDiagnostic Radiology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1073838249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W CHICAGO AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606427983",
            "telephone_number": "312-608-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W CHICAGO AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606427983",
            "telephone_number": "312-608-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "HANNAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125056446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.