Provider Demographics
NPI:1386924082
Name:KYLE, JAMES K
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:K
Last Name:KYLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 W ARGYLE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2603
Mailing Address - Country:US
Mailing Address - Phone:773-878-9077
Mailing Address - Fax:
Practice Address - Street 1:4343 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-1817
Practice Address - Country:US
Practice Address - Phone:773-427-9456
Practice Address - Fax:773-427-9469
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-036911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist