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Individual
KYLE DUFFEE
Active
Individual
KYLE DUFFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008150
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
MEDICARE GROUP NUMBER
IL
01
—
599990
MEDICARE GROUP NUMBER
IL
01
—
600040
MEDICARE GROUP NUMBER
IL
Enumeration date
12/05/2007
Last updated
12/02/2008
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