Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Logan Mark Koi, PA-C

Individual provider Physician Assistant · NPI 1902637069

Logan Mark Koi, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2024, 2 years ago. Practices with Orthomidwest, PLLC, a 537-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois and Indiana.

Years since qualifying
2
Licensed in
IL, IN
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Phone: (877) 632-6637
Fax: (708) 409-5179
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9200 Calumet Ave Ste 300, Munster, IN 46321-2885 — (877) 632-6637

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085011021 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 10004716A (IN)

Record details

NPI number1902637069
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 12, 2024
Last updated in NPPESJanuary 24, 2025
Certification dateJanuary 24, 2025
Mailing address1611 W Harrison St Ste 400, Chicago, IL 60612-4861

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Orthomidwest, Pllc — 537 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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