MEDICARE: DR. C. NEIL KAY B.D.S.,M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry		IL

General Provider Information

NPI Number	:	1629297999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. C. NEIL KAY B.D.S.,M.S.

Provider Business Mailing Address
First Line	:	175 E DELAWARE PL
Second Line	:	9108
City	:	CHICAGO
State	:	IL
Zip	:	60611-1756
Country	:	US
Telephone Number	:	630-567-2779
Fax Number	:	630-896-9252

Provider Business Practice Location Address
First Line	:	25 BOULDER HILL PASS
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-1911
Country	:	US
Telephone Number	:	630-896-2779
Fax Number	:	630-896-9252

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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