Individual provider Active NPI

Kyle Brodie Sarlls, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1417658097
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.01135 Issued in IL
Practice address
3665 N Broadway St
Chicago, IL 60613-4567
Phone
(903) 815-9309
NPI assigned
Mar 13, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.01135 IL Primary

Addresses

Primary practice location

3665 N Broadway St
Chicago, IL 60613-4567

Mailing address

5635 N Wayne Ave Apt 3N
Chicago, IL 60660-0070
Phone (903) 815-9309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260219002034 IL Practitioner - Physician Assistant 2264977933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Clinic LLCGroup PAC ID 7517284755, 110 clinicians

Practice addresses (Care Compare)

1 E Superior St
Suite 306
Chicago, IL 60611-2595
Phone (312) 754-9404

3665 N Broadway St
Chicago, IL 60613-4567
Phone (773) 496-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.01135ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Clarity Clinic PLLC Physician Assistant CurrentSince Mar 2, 2026 Accepting new patients

Locations

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

3665 N Broadway St
Chicago, IL 60613
Phone (773) 496-4433

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1417658097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 N WAYNE AVE APT 3N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606600070",
            "telephone_number": "903-815-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134567",
            "telephone_number": "903-815-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARLLS",
        "first_name": "KYLE",
        "middle_name": "BRODIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-13",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.01135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.