Troy Michael Doetch, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

53455 Issued in WI

Practice address

1200 Candlewick Dr NW
Poplar Grove, IL 61065

Phone

(815) 985-6929

NPI assigned

Jul 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1790718104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CANDLEWICK DR NW",
            "city": "POPLAR GROVE",
            "state": "IL",
            "postal_code": "610658920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CANDLEWICK DR NW",
            "city": "POPLAR GROVE",
            "state": "IL",
            "postal_code": "61065",
            "telephone_number": "815-985-6929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 S Main St",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "WI",
            "postal_code": "535751534",
            "country_code": "US",
            "telephone_number": "608-835-5588",
            "fax_number": "608-835-8026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOETCH",
        "first_name": "TROY",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "53455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laura Grant, PHD, CF-SLP

• Family Medicine Physician in Poplar Grove, IL
• Providers in Poplar Grove, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.