Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Nicholas Brent Koch, AGPCNP-BC

Individual provider Gerontology Nurse Practitioner · NPI 1750162780

Mr. Nicholas Brent Koch, AGPCNP-BC is a Nurse Practitioner in Chicago, Illinois. Qualified in 2023, 3 years ago. Practices with Near North Health Service Corporation, a 27-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

150 E Huron St Ste 1101
Chicago, IL 60611-2948
Phone: (312) 741-8554
Fax: (312) 216-1779
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 209.028387 (IL)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 209.028387 (IL)

Record details

NPI number1750162780
Entity typeIndividual (Type 1)
GenderMale
Credentials AGPCNP-BC
Sole proprietorNo
NPI enumeratedOctober 5, 2023
Last updated in NPPESNovember 23, 2024
Certification dateNovember 23, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Near North Health Service Corporation — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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