Organization
DOCTORS EGLY AND ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN D EGLY MD (CEO)
(815) 786-6988
Entity
Organization
Contact information
Practice address
11 E PLEASANT AVE, SUITE 129, SANDWICH, IL 60548-1100
(815) 786-6988
(815) 786-1418
Mailing address
203 WILLOWWOOD DR, OSWEGO, IL 60543-7505
(815) 786-6988
(815) 786-1418
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
060.009347 036.10105
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01932032
BCBS GROUP #
IL
Enumeration date
04/12/2007
Last updated
03/03/2011
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