Individual
KYLE PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 RIDGE AVE., DEPT. OF ANESTHESIA, EVANSTON, IL 60201
(847) 570-2760
Mailing address
2650 RIDGE AVE., DEPT. OF ANESTHESIOLOGY, EVANSTON, IL 60201
(847) 570-2760
(847) 570-2921
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036159935
IL
207L00000X
Anesthesiology Physician
125.072135
IL
Other
Enumeration date
06/18/2018
Last updated
12/28/2022
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