Provider Demographics
NPI:1932542602
Name:KOYA, KOMAL D (DO)
Entity Type:Individual
Prefix:DR
First Name:KOMAL
Middle Name:D
Last Name:KOYA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CHESTNUT ST # 205
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3700
Mailing Address - Country:US
Mailing Address - Phone:630-654-3376
Mailing Address - Fax:
Practice Address - Street 1:333 CHESTNUT ST STE 205
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3700
Practice Address - Country:US
Practice Address - Phone:630-654-3376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036139072208M00000X
IL125.063964207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist