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1639204613
LAKE STREET FAMILY MEDICINE, LLC
ADDISON, IL
NPI
1639204613
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Entity Type
Organization
Authorized Contact
BRIAN KOECHER
Physician
630-516-0434
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2007-02-22
Last Update Date
2012-12-11
Business Address
LAKE STREET FAMILY MEDICINE, LLC
220 E LAKE ST SUITE 100
ADDISON, IL 60101-2887
Phone number: 630-516-0434
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Mailing Address
LAKE STREET FAMILY MEDICINE, LLC
220 E LAKE ST SUITE 100
ADDISON, IL 60101-2887
Phone number: 630-516-0434
Copy
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