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General NPI Number Information
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NPI Number | 1225861818
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Entity Type | Organization
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Legal Business Name | LAUREN E KOCH DDS PC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2896 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60618-7413
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Country | US
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Telephone | 773-295-6439
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Fax | 773-295-6690
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Provider Business Mailing Address
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Address Line | 2450 N AVERS AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2224
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Country | US
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Telephone | 517-673-1967
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAUREN EMILY KOCH MACDONALD
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Credential | DDS
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Telephone | 517-673-1967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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