Dessie Koehler, RT(R) RDMS RVT
Individual provider Active NPI Diagnostic Ultrasound Physician · Saint Peter, IL
NPI 1609498575 · NPPES record last updated May 13, 2020
Key facts
- NPI
- 1609498575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Ultrasound Physician 2085U0001X
- License
- 147933 (IL)
- Practice address
- 110 W. 2ND St.
Saint Peter, IL 62880 - Phone
- (618) 339-1746
- NPI assigned
- May 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 147933 | IL | MD | Diagnostic Ultrasound Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Ultrasound Physician | 2085U0001X | 147933 | IL | Yes |
Addresses
Primary practice location
110 W. 2ND St.
Saint Peter, IL 62880
Mailing address
110 W. 2ND St.
Saint Peter, IL 62880
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | none |
Other providers in Saint Peter, IL
All providers in Saint Peter, IL · Diagnostic Ultrasound Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2020. 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.