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General NPI Number Information
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NPI Number | 1487996617
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Entity Type | Individual
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Provider Name | KAREN A KOENIG NP
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Gender | Female
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 1304 BURNETT DR
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City | TAYLORVILLE
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State | IL
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Zip | 62568-9519
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Country | US
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Telephone | 217-321-9310
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Fax | 217-321-9307
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Provider Business Mailing Address
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Address Line | 2603 S 6TH ST
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City | SPRINGFIELD
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State | IL
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Zip | 62703-3807
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Country | US
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Telephone | 217-528-0307
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Fax | 217-528-0034
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209010343
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License Number State | IL
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