Individual
MS. KAYLA ANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-8000
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-2944
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085-006260
IL
Other
Enumeration date
07/19/2017
Last updated
06/22/2023
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