Susan Hatfield Koch, SUSAN KOCH M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036090747 Issued in IL

Practice address

456 Frontage Rd
Suite 28
Northfield, IL 60093-3034

Phone

(847) 707-2600

NPI assigned

Dec 27, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1261872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261872000000",
    "number": "1548590482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 FRONTAGE RD",
            "address_2": "SUITE 28",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933034",
            "telephone_number": "847-707-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 FRONTAGE RD",
            "address_2": "SUITE 28",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933034",
            "telephone_number": "847-707-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "SUSAN",
        "middle_name": "HATFIELD",
        "name_prefix": "Mrs.",
        "credential": "SUSAN KOCH M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-27",
        "last_updated": "2009-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "336052360",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036090747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Y Kim, LSW
• Dikran Kirilescu Jr., D.D.S.
• Denise Kitanovski
• Alison Faye Kleiman
• Katie Elizabeth Klein
• Petros Kokinis, APRN
• Mimi S Kravitz, MSW;LCSW
• Cathy Kreisel, LCSW
• James Kudrna, MD
• Ellen Joy Kupchick, LCSW

• Child & Adolescent Psychiatry Physician in Northfield, IL
• Providers in Northfield, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.