MEDICARE: DR. DOUGLAS L. KAY D.D.S.

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	1223G0001X	General Practice Dentistry	019017846	IL

General Provider Information

NPI Number	:	1730182486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS L. KAY D.D.S.

Provider Business Mailing Address
First Line	:	17 W 535 BUTTERFIELD ROAD
Second Line	:	SUITE 201
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-5628
Country	:	US
Telephone Number	:	630-834-7446
Fax Number	:	630-834-7490

Provider Business Practice Location Address
First Line	:	17 W 535 BUTTERFIELD ROAD
Second Line	:	SUITE 201
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-5628
Country	:	US
Telephone Number	:	630-834-7446
Fax Number	:	630-834-7490

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	09/02/2010

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