Provider Demographics
NPI:1770802548
Name:DOLAR R KOYA MD SC
Entity type:Organization
Organization Name:DOLAR R KOYA MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOLAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:KOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-892-6300
Mailing Address - Street 1:1177 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-2281
Mailing Address - Country:US
Mailing Address - Phone:630-892-6300
Mailing Address - Fax:630-892-6379
Practice Address - Street 1:1177 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2281
Practice Address - Country:US
Practice Address - Phone:630-892-6300
Practice Address - Fax:630-892-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036055698174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty