Healthcare Provider Details

I. General information

NPI: 1194704213
Provider Name (Legal Business Name): KYLE BONESTEEL PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 BUTTERFIELD RD STE 100
OAK BROOK IL
60523-1184
US

IV. Provider business mailing address

2805 BUTTERFIELD RD STE 100
OAK BROOK IL
60523-1184
US

V. Phone/Fax

Practice location:
  • Phone: 630-969-3323
  • Fax: 630-969-3310
Mailing address:
  • Phone: 630-969-3233
  • Fax: 630-969-3310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number71006163
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: