Kyle Boyd, ATC

Individual provider Active NPI Athletic Trainer · Hillside, IL

NPI 1003206160 · NPPES record last updated Jan 28, 2015

Key facts

NPI
1003206160
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
096002824 (IL)
Practice address
326 Clayton Ave
Hillside, IL 60162-1613
Phone
(708) 642-5953
NPI assigned
Jan 28, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
096002824ILMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096002824 IL Yes

Addresses

Primary practice location

326 Clayton Ave
Hillside, IL 60162-1613

Mailing address

326 Clayton Ave
Hillside, IL 60162-1613
Phone (708) 642-5953

Other providers in Hillside, IL

All providers in Hillside, IL · Athletic Trainer in Illinois

Sources for this page

Verify at the official NPI Registry.