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NPI Code Detail

MEDICARE: CHRISTOPHER KOENTZ

MEDICARE: CHRISTOPHER KOENTZ
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
1183500000XPharmacist051.294973IL

General Provider Information

NPI Number : 1700276417
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER KOENTZ
Provider Business Mailing Address
First Line : 802 E NORTHWEST HWY
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-6233
Country : US
Telephone Number : 847-253-5494
Fax Number : 847-253-5508
Provider Business Practice Location Address
First Line : 802 E NORTHWEST HWY
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-6233
Country : US
Telephone Number : 847-253-5494
Fax Number : 847-253-5508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2015
Last Update Date : 02/02/2015

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Directions to “ CHRISTOPHER KOENTZ ” Practice Location

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