Provider Demographics
NPI:1164434809
Name:D MICHAEL KAYE MD PC
Entity Type:Organization
Organization Name:D MICHAEL KAYE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:D
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-334-0575
Mailing Address - Street 1:5701 NORTH ASHLAND AVENUE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4014
Mailing Address - Country:US
Mailing Address - Phone:773-334-0575
Mailing Address - Fax:773-334-0665
Practice Address - Street 1:5701 NORTH ASHLAND AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4014
Practice Address - Country:US
Practice Address - Phone:773-334-0575
Practice Address - Fax:773-334-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0031603133OtherBLUE SHIELD
IL0031603133OtherBLUE SHIELD
D16538Medicare UPIN