Active NPI
Kenneth Troy Koch, PHARMD
- Pharmacist
- Oak Park, IL
National Provider Identifier
1982033429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 011159
- Practice address
- 216 N Taylor Ave
Oak Park, IL 60302-2526 - Phone
- (708) 545-8833
- NPI assigned
- Nov 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 011159 | KY | Primary |
| Pharmacist | 183500000X | 051.296889 | IL |
Addresses
Primary practice location
216 N Taylor Ave
Oak Park, IL 60302-2526
Mailing address
216 N Taylor Ave
Oak Park, IL 60302-2526
Phone (708) 545-8833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.296889 | IL | MD | Pharmacist |
| 011159 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383609600000",
"number": "1982033429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 N TAYLOR AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603022526",
"telephone_number": "708-545-8833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 N TAYLOR AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603022526",
"telephone_number": "708-545-8833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "KENNETH",
"middle_name": "TROY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-05",
"last_updated": "2013-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "011159",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.296889",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.