Provider Demographics
NPI:1962214213
Name:KOCH, ELIZABETH (CD,(DONA))
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:KOCH
Suffix:
Gender:F
Credentials:CD,(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 INDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-3137
Mailing Address - Country:US
Mailing Address - Phone:630-892-4355
Mailing Address - Fax:
Practice Address - Street 1:1400 INDIAN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-3137
Practice Address - Country:US
Practice Address - Phone:630-892-4355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula