Active NPI
Anthony R Koebler
- Surgical Assistant
- Elgin, IL
National Provider Identifier
1245483908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 1435 N Randall Rd
Suite 103
Elgin, IL 60123-2306 - Phone
- (847) 888-0750
- Fax
- (847) 888-2152
- NPI assigned
- Oct 28, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | Primary |
Addresses
Primary practice location
1435 N Randall Rd
Suite 103
Elgin, IL 60123-2306
Mailing address
1435 N Randall Rd
Suite 103
Elgin, IL 60123-2306
Phone (847) 888-0750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 057551 | Other | IL | NATIONAL CERTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1245483908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1435 N RANDALL RD",
"address_2": "SUITE 103",
"city": "ELGIN",
"state": "IL",
"postal_code": "601232306",
"telephone_number": "847-888-0750",
"fax_number": "847-888-2152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1435 N RANDALL RD",
"address_2": "SUITE 103",
"city": "ELGIN",
"state": "IL",
"postal_code": "601232306",
"telephone_number": "847-888-0750",
"fax_number": "847-888-2152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEBLER",
"first_name": "ANTHONY",
"middle_name": "R",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-28",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CERTIFICATION",
"identifier": "057551",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.