Doctor Name: | KYLE GADBOIS |
NPI Number: | 1164718102 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 5616 W 63rd St Chicago, IL - 606385511 |
Business Phone Number: | 7735265239 |
Business Fax Number: | |
Mailing Address: | 790 Remington Blvd, BOLINGBROOK |
State: | IL |
Postal Code: | 604404909 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/28/2011 |
NPI Last Update Date: | 06/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225500000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |