Individual
KYLE COX BLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2454 E DEMPSTER ST STE 400, DES PLAINES, IL 60016-5320
(847) 299-0700
(847) 390-0616
Mailing address
2454 E DEMPSTER ST STE 400, DES PLAINES, IL 60016-5320
(541) 990-5464
(847) 390-0616
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036.159412
IL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
036.159412
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
05/13/2016
Last updated
07/26/2022
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