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General NPI Number Information
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NPI Number | 1710092655
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Entity Type | Individual
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Provider Name | KEVIN D EGLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 11 E PLEASANT AVE ROOM 129
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City | SANDWICH
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State | IL
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Zip | 60548-1100
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Country | US
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Telephone | 815-786-6988
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Fax | 815-786-1418
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Provider Business Mailing Address
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Address Line | 203 WILLOWWOOD DR
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City | OSWEGO
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State | IL
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Zip | 60543-7505
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Country | US
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Telephone | 630-554-0074
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Fax |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036101052
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036101052
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License Number State | IL
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