Stanley W Koch (NPI# 1467436436, PAC ID# 3779530845) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1467436436 |
| PAC ID by PECOS | 3779530845 |
| Professional Enrollment ID | I20050404000301 |
| Full Name | Stanley W Koch |
| Organization Legal Name | KOCH FAMILY MEDICINE SC |
| Address |
411 Maxine Dr Morton IL 61550-2495 |
| Phone Number | 3092632411 |
| Gender | M |
| Credential | MD |
| Medical School | SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1979 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1153378229 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140067 | OSF SAINT FRANCIS MEDICAL CENTER |
| 140209 | METHODIST MEDICAL CENTER OF ILLINOIS |
| 140120 | PEKIN MEMORIAL HOSPITAL |
| 140013 | PROCTOR HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 411 Maxine Dr, Morton, IL 61550-2495 | 3092632411 | KOCH FAMILY MEDICINE SC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 99% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 94% |
| Organization Legal Name | KOCH FAMILY MEDICINE SC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anna R Stiker | Physical Therapy | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Kimberly Y Ford | Family Medicine | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Andrew A Aberle Ii | Physical Therapy | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Angela J Gilles | Nurse Practitioner | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Ashley Irene Lynn | Nurse Practitioner | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Ashlee Denooy | Physical Therapy | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Street Address |
411 MAXINE DR |
| City | MORTON |
| State | IL |
| Zip | 61550-2495 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yibing Li | Physical Medicine and Rehabilitation | Center for Pain Management and Rehab, S. C . | 411 Maxine Dr, Morton, IL 61550-2495 |
| Anna R Stiker | Physical Therapy | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Kimberly Y Ford | Family Medicine | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Andrew A Aberle Ii | Physical Therapy | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Angela J Gilles | Nurse Practitioner | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Ashley Irene Lynn | Nurse Practitioner | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Ashlee Denooy | Physical Therapy | Koch Family Medicine Sc | 411 Maxine Dr, Morton, IL 61550-2495 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David J Walsh | Physical Therapy | Professional Therapy Services Inc | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Patricia J Geisz | Physical Therapy | Professional Therapy Services Inc | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Anthony Schupp | Physical Therapy | Professional Therapy Services Inc | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Jennah Siwak | Family Medicine | Iowa Physicians Clinic Medical Foundation | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Ashley N Brandt | Nurse Practitioner | Iowa Physicians Clinic Medical Foundation | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Nicole Kaltwasser | Physical Therapy | Professional Therapy Services Inc | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Stephanie J Shepherdson | Physical Therapy | Professional Therapy Services Inc | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Emily K Getz | Physical Therapy | Professional Therapy Services Inc | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Taariq Goder | Family Medicine | Iowa Physicians Clinic Medical Foundation | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Mary E Gerig | Physical Therapy | Professional Therapy Services Inc | 1909 N Morton Ave, Morton, IL 61550-1426 |
| Find all physicians in zip 61550 | |||
| City | MORTON |
| Zip Code | 61550 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MORTON + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.