MRS. KYLIE L MACK (NPI# 1467705392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467705392 |
| Entity Type | Individual |
| Full Name | MRS. KYLIE L MACK |
| Credential | PA-C |
| Practice Address |
351 Delnor Dr #100 Geneva IL 60134 |
| Practice Telephone | 6302621001 |
| Practice Fax Number | 6302628065 |
| Mailing Telephone | 6302621001 |
| Mailing Fax Number | 6302628065 |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2019-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085004411 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085.004411 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
351 DELNOR DR #100 |
| City | GENEVA |
| State | IL |
| Zip Code | 60134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902403918 | Glenda Creighton | Physical Therapist | 0n 801 Friendship Way, Geneva, IL 60134 | 2020-10-02 |
| 1467912212 | Cierra Monae French | Family Medicine | Northwestern Medicine Delnor Hospital, 300 Randall Road, Geneva, IL 60134 | 2019-03-20 |
| 1497246227 | Linda Huber | Psychologist | 1541 E Fabyan Pkwy Ste 101, Geneva, IL 60134 | 2018-05-29 |
| 1003305459 | Nicole Collins | Specialist/Technologist | 1125 Lewis Road, Geneva, IL 60134 | 2018-05-01 |
| 1013438704 | Emily Byars | Clinic/Center | 1111 Greenfield Circle, Geneva, IL 60134 | 2017-07-03 |
| 1982142980 | Samantha Courtney | Counselor | 1120 Randall Ct., Geneva, IL 60134 | 2017-02-09 |
| 1073055026 | Physical Rehabilitation Clinics | Physical Therapist | 507 S. 3rd St. Unit I, Geneva, IL 60134 | 2016-11-08 |
| 1265868707 | Gina Marie Gilchrist | Dietitian, Registered | 39w479 W Haladay Ln, Geneva, IL 60134 | 2013-09-16 |
| 1770823585 | William A. Goodfellow | General Practice | 1010 S. Batavia Ave., Geneva, IL 60134 | 2013-02-15 |
| 1942557806 | Bridget Kulik | Music Therapist | 39w148 E. Mallory Dr., Geneva, IL 60134 | 2012-08-10 |
| Find all providers in zip 60134 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245752716 | Kristin Marie Stokes | Physician Assistant | 1150 Ny-5, Geneva, NY 14456 | 2017-07-17 |
| 1265442370 | James Schiltz | Physician Assistant | 2535 Soderquist Ct, Geneva, IL 60134-3593 | 2006-08-09 |
| 1639166192 | Timothy L Button | Physician Assistant | 789 Pre-emption Rd, Suite 600, Geneva, NY 14456 | 2005-09-30 |
| 1538774641 | Kayla Christine Montgomery | Physician Assistant | 870 W Main St, Geneva, OH 44041-1219 | 2020-09-15 |
| 1982238135 | Rena Ranallo | Physician Assistant | 2525 Kaneville Rd, Geneva, IL 60134-2578 | 2020-02-26 |
| 1942843099 | Jessica Flowers | Physician Assistant | 870 W Main St, Geneva, OH 44041-1219 | 2019-10-22 |
| 1861035800 | Scott Louis Danner | Physician Assistant | 870 W Main St, Geneva, OH 44041-1219 | 2019-10-22 |
| 1821557554 | Lauren Turner | Physician Assistant | 60 West St, Geneva, OH 44041-9723 | 2019-03-12 |
| 1902364862 | Nathaniel Robert Bucci | Physician Assistant | 60 West St, Geneva, OH 44041-9723 | 2019-03-08 |
| 1093220592 | Lauren Elizabeth Miser | Physician Assistant | 2425 Fargo Blvd, Geneva, IL 60134-3591 | 2017-12-06 |
| Find all providers in GENEVA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.