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1417027145
DIANE M. KOCH
URBANA, IL
NPI
1417027145
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209001138)
Enumeration Date
2006-11-09
Last Update Date
2015-04-20
Business Address
-- DIANE M. KOCH NP
611 W. PARK ST.
URBANA, IL 61801-2500
Phone number: 217-383-3140
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Mailing Address
-- DIANE M. KOCH NP
611 W. PARK ST. BWPC
URBANA, IL 61801-2500
Phone number: 217-383-6792
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