Robert J Koch, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036085152 Issued in IL

Practice address

1870 W Winchester Rd Ste 241
Libertyville, IL 60048-5360

Phone

(847) 549-0170

Fax

(847) 549-0172

NPI assigned

Sep 15, 2005

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

Other identifiers 3

Electronic endpoints 2

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Heart SpecialistsGroup PAC ID 6305749490, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
• Vista Medical Center East Hospital, Waukegan, IL, CCN 140084

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robertkoch@lhs.allscriptsdirect.net
• Direct secure messaging: rkoch236532@direct.myadvocateaurora.org

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

• Lake Heart Specialists

  • Cardiovascular Disease Physician
  • Gurnee, IL
  • NPI 1629063391
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation
• Waukegan Illinois Hospital Company LLC

  • General Acute Care Hospital
  • Waukegan, IL
  • NPI 1639120694
  Care Compare affiliation

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1962497974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD STE 241",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485360",
            "telephone_number": "847-549-0170",
            "fax_number": "847-549-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD STE 241",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485360",
            "telephone_number": "847-549-0170",
            "fax_number": "847-549-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036085152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085152",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPIN",
            "identifier": "1456310",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5031191",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkoch236532@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1870 W Winchester Rd Ste 241",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1870 W Winchester Rd Ste 241",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katarzyna Klimas-Osolkowski, MD
• Lauren Kliska, OTR/L
• Allison Klotzbuecher, D.O.
• Paulina Kluchka
• Madeline Knoll, LCSW
• Stacy Anne Koch, LCSW
• Michael Bernard Kocher, LCSW
• Koffel Medical Supply Inc
• Candia A. Koleszar, RPH
• Karyn Kolner, DPT

• Cardiovascular Disease Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.