Individual provider Active NPI

Craig D Koch, M.D

  • Emergency Medicine Physician
  • Peoria, IL
National Provider Identifier
1083020218
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125064826 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-7257
NPI assigned
Jul 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125064826 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

10948 Locust Rd
Tremont, IL 61568-9015

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
I20170919002869 IL Practitioner - Emergency Medicine 8325369044 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Southern Illinois University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4281

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epss LLC - Central Series Emergency Medicine CurrentSince Jan 1, 2022 Accepting new patients
Epss, LLC- Metro Series Emergency Medicine CurrentSince Dec 8, 2021 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 1, 2017 Accepting new patients
Saint Francis Medical Center CurrentSince Dec 11, 2018 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 1, 2017 Accepting new patients
Epss Peoria LLC Emergency Medicine CurrentSince Jan 1, 2022 Accepting new patients
Saint Francis Medical Center CurrentSince Dec 11, 2018 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Oct 15, 2023 Accepting new patients
Carle Health Care Incorporated Emergency Medicine CurrentSince Jan 1, 2026 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2021 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Oct 15, 2023 Accepting new patients
Stephen C. Thompson, M.D.,S.C. Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

600 E 1st St
Spring Valley, IL 61362
Phone (815) 664-1477

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: ckochmd388380@carlehiedirect.net

Organizations & group practices 15

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

View all 15

Hospital & facility affiliations 1

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1083020218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10948 LOCUST RD",
            "city": "TREMONT",
            "state": "IL",
            "postal_code": "615689015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-7257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "CRAIG",
        "middle_name": "D",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125064826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.