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General NPI Number Information
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NPI Number | 1013711563
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Entity Type | Individual
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Provider Name | MADELINE KOESTER APRN
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 1000 PALM AVE
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City | MATTOON
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State | IL
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Zip | 61938-6031
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Country | US
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Telephone | 217-234-7403
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Fax |
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Provider Business Mailing Address
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Address Line | 222 COUNTY ROAD 500 E
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City | SIGEL
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State | IL
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Zip | 62462-2107
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Country | US
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Telephone | 217-994-1480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209031415
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License Number State | IL
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