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General NPI Number Information
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NPI Number | 1649308735
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Entity Type | Individual
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Provider Name | KYLE MICHAEL COOK MPT
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 8192 S CASS AVE
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City | DARIEN
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State | IL
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Zip | 60561
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Country | US
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Telephone | 708-801-1005
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Fax | 708-810-8686
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Provider Business Mailing Address
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Address Line | 20632 S IVY PATH
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City | FRANKFORT
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State | IL
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Zip | 60423-8742
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Country | US
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Telephone | 763-360-1823
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Fax | 708-810-8686
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 070019705
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.019705
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License Number State | IL
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