Individual
KYLE DUFFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
2400 N SHEFFIELD AVE, CHICAGO, IL 60614-2215
(773) 281-7991
(773) 281-2590
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216
(312) 640-0329
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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