Individual
KYLE COWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6901 S OGLESBY AVE APT 3B, CHICAGO, IL 60649-1827
(773) 610-0739
Mailing address
6901 S OGLESBY AVE APT 3B, CHICAGO, IL 60649-1827
(773) 610-0739
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
C630-5017-7015
IL
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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