Individual
KYLE A KALCHBRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
901 MCCLINTOCK DR, STE 202, BURR RIDGE, IL 60527-0872
(888) 220-6432
(630) 734-4715
Mailing address
901 MCCLINTOCK DR, STE 202, BURR RIDGE, IL 60527-0872
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085005103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F4001671673
MEDICARE NUMBER
IL
01
—
F4001671675
MEDICARE NUMBER
IL
01
—
F4001671676
MEDICARE NUMBER
IL
Enumeration date
07/31/2014
Last updated
12/17/2021
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