Kyle Childers Specialty Partners of Illinois, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

KYLE CHILDERS SPECIALTY PARTNERS OF ILLINOIS, PLLC

Practice address

201 W Washington St
Benton, IL 62812-1382

Phone

(618) 438-2815

NPI assigned

Oct 16, 2025

Organization subpart

No

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

Authorized official

Name

Krystal Richardson

Title

Director of Revenue Cycle

Phone

(214) 934-7995

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle R Childers, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Benton, IL
  • NPI 1699914762
  NPD (past)

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1952277824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W 42ND ST STE 2300",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693615016",
            "telephone_number": "308-260-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W WASHINGTON ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121382",
            "telephone_number": "618-438-2815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Small St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629463325",
            "country_code": "US",
            "telephone_number": "618-252-0770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3315 Patriot Ct",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483782",
            "country_code": "US",
            "telephone_number": "618-997-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KYLE CHILDERS SPECIALTY PARTNERS OF ILLINOIS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "214-934-7995"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Lorraine Kimmel, FNP
• Jenna Kirkpatrick, PHARMD
• Logan Edward Kirkpatrick, RN
• Luke William Koehn, D.C.
• Melissa A Kramer, MS, CCC-SLP
• Kyle R Childers DMD Ms PC
• Robin S Labuwi, D.M.D,
• Ralph I Latta, MD
• Randall Wayne Lawrence, PT
• Cindy L Lord, FNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Benton, IL
• Providers in Benton, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.