Provider Demographics
NPI:1841264983
Name:KOH, MEGAN (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KOH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MEGAN
Other - Middle Name:KOH
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:120 N OAK ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3829
Mailing Address - Country:US
Mailing Address - Phone:630-312-7865
Mailing Address - Fax:
Practice Address - Street 1:120 N OAK ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3829
Practice Address - Country:US
Practice Address - Phone:630-856-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36107464207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036107464Medicaid
IL036107464Medicaid
H17791Medicare UPIN
ILK22500Medicare ID - Type Unspecified
INK22501Medicare ID - Type Unspecified