MEDICARE: DOLAR R. KOYA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	036055698	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164493417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOLAR R. KOYA MD

Provider Business Mailing Address
First Line	:	1177 N HIGHLAND AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60506-2281
Country	:	US
Telephone Number	:	630-892-6300
Fax Number	:	630-892-6379

Provider Business Practice Location Address
First Line	:	1177 N HIGHLAND AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60506-2281
Country	:	US
Telephone Number	:	630-892-6300
Fax Number	:	630-892-6379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	01/25/2026

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