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Organization

KYLE CHILDERS SPECIALTY PARTNERS OF ILLINOIS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRYSTAL RICHARDSON (DIRECTOR OF REVENUE CYCLE)
(214) 934-7995
Entity
Organization

Contact information

Practice address
201 W WASHINGTON ST, BENTON, IL 62812-1382
(618) 438-2815
Mailing address
820 W 42ND ST STE 2300, SCOTTSBLUFF, NE 69361-5016
(308) 260-0241

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
10/16/2025
Last updated
10/16/2025
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