Lake Street Family Medicine, LLC

NPI #1639204613 in Addison, Illinois

Provider Information

NPI Number
1639204613
Entity Type
Organization
Organization Name
Lake Street Family Medicine, LLC
Primary Specialty
Family Medicine
Enumeration Date
Feb 22, 2007
Last Updated
Dec 11, 2012

Practice Location

Address
220 E LAKE ST
Address 2
SUITE 100
ZIP Code
60101-2887
Phone
(630) 516-0434

Authorized Official

Name
BRIAN KOECHER, D.O.
Title
PHYSICIAN
Phone
(630) 516-0434

Specialties & Taxonomy Codes

Specialty
Family Medicine

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