Provider Demographics
NPI:1063497063
Name:KAY, RICHARD M (PA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:KAY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:8858 S CRANDON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3027
Mailing Address - Country:US
Mailing Address - Phone:773-731-7344
Mailing Address - Fax:773-768-4119
Practice Address - Street 1:8858 S CRANDON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3027
Practice Address - Country:US
Practice Address - Phone:773-731-7344
Practice Address - Fax:773-768-4119
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant