Doctor Name: | MR. EDWIN DEWEES KYLE |
NPI Number: | 1043430812 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PAC |
License Number: | |
Business Practice Address: | 9600 Gross Point Road Rush North Shore Medical Center Dept Of Surgery Skokie, IL - 60076 |
Business Phone Number: | 8479336020 |
Business Fax Number: | |
Mailing Address: | 3032 Park Place, EVANSTON |
State: | IL |
Postal Code: | 60201 |
Phone Number: | 2246192189 |
Fax Number: | |
NPI Enumeration Date: | 04/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |