Amy L Koehler, MS-CCC-A
Individual provider Active NPI Audiologist · Ottawa, IL
NPI 1962744581 · NPPES record last updated Mar 21, 2013
Key facts
- NPI
- 1962744581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 147000989 (IL)
- Practice address
- 1050 E Norris Dr
Suite 2a
Ottawa, IL 61350-1605 - Phone
- (815) 431-5327
- Fax
- (815) 431-5691
- NPI assigned
- Mar 21, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 147000989 | IL | Yes |
Addresses
Primary practice location
1050 E Norris Dr
Suite 2a
Ottawa, IL 61350-1605
Mailing address
1100 E Norris Dr
Attn: Audiology
Ottawa, IL 61350-1604
Phone (815) 431-5327
Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2013. 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.