Individual
KYLE SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1009 HIGHWAY 22 STE 1, FOX RIVER GROVE, IL 60021-1998
(847) 462-8707
(847) 462-9208
Mailing address
900 RAND RD STE 300, DES PLAINES, IL 60016-2359
(847) 324-3976
(847) 929-1154
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160-009371
IL
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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