Gary L Koehn, MD, PHD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in La Grange Highlands, Illinois. His current practice location is
5201 Willow Springs Rd, Suite 110, La Grange Highlands, Illinois. You can reach out to his office (for appointments etc.) via phone at
(708) 482-4500.
Gary L Koehn is licensed to practice in Illinois (license number 036074138) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1992758965.
Physician's Profile
| Full Name | Gary L Koehn |
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| Gender | Male |
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| Speciality | Pain Medicine - Interventional Pain Medicine |
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| Location | 5201 Willow Springs Rd, La Grange Highlands, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1992758965
- Provider Enumeration Date: 05/18/2006
- Last Update Date: 11/08/2012
Medicare PECOS Information:
- PECOS PAC ID: 8022061902
- Enrollment ID: I20050303000127
Medical Identifiers
Medical identifiers for Gary L Koehn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992758965 | NPI | - | NPPES |
| 030038 | Other | IL | HEALTH ALLIANCE ID |
| 01608719 | Other | IL | BLUE CROSS PROVIDER NO. |
| 132321800 | Other | IL | US DEPT OF LABOR GROUP |
| 1164451308 | Other | IL | GL KOEHN ASSOC GROUP NPI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | 25969 (Wisconsin) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 036074138 (Illinois) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 036074138 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gary L Koehn allows following entities to bill medicare on his behalf.
| Entity Name | Modern Pain Consultants |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164451308
PECOS PAC ID: 1153374038
Enrollment ID: O20050303000074 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gary L Koehn is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Gary L Koehn, MD, PHD
5201 Willow Springs Rd, Suite 110,
La Grange Highlands, IL 60525-6537
Ph: (708) 482-4500 | Gary L Koehn, MD, PHD
5201 Willow Springs Rd, Suite 110,
La Grange Highlands, IL 60525-6537
Ph: (708) 482-4500 |
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