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General NPI Number Information
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NPI Number | 1881012474
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Entity Type | Individual
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Provider Name | KYLE T AMBER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 3249 S. OAK PARK AVENUE
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City | BERWYN
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State | IL
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Zip | 60402
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Country | US
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Telephone | 708-783-3403
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Fax |
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Provider Business Mailing Address
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Address Line | 808 S WOOD ST RM 380
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City | CHICAGO
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State | IL
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Zip | 60612-7300
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Country | US
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Telephone |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 142376
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036145831
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License Number State | IL
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