Individual provider Active NPI

Kyle Coward

  • Other Technician
  • Chicago, IL
National Provider Identifier
1225498777
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
License
C630-5017-7015 Issued in IL
Practice address
6901 S Oglesby Ave Apt 3B
Chicago, IL 60649-1827
Phone
(773) 610-0739
NPI assigned
Feb 25, 2016
Last updated
Feb 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X C630-5017-7015 IL Primary

Addresses

Primary practice location

6901 S Oglesby Ave Apt 3B
Chicago, IL 60649-1827

Mailing address

6901 S Oglesby Ave Apt 3B
Chicago, IL 60649-1827
Phone (773) 610-0739

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C630-5017-7015ILMDOther Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1225498777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 S OGLESBY AVE APT 3B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606491827",
            "telephone_number": "773-610-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 S OGLESBY AVE APT 3B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606491827",
            "telephone_number": "773-610-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWARD",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "IL",
            "license": "C630-5017-7015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.