MEDICARE: C. NEIL KAY ORTHODONTICS PC

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	021001221	IL

General Provider Information

NPI Number	:	1902882103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C. NEIL KAY ORTHODONTICS PC

Provider Business Mailing 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

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	:	OWNER/DOCTOR
Name	:	DR. C. NEIL KAY
Credential	:	BDS, MS
Telephone Number	:	630-896-2779

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	05/15/2015

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