Provider Demographics
NPI:1336699255
Name:MCKINLEY, KYLE AARON (CRNP)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:AARON
Last Name:MCKINLEY
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 E ONTARIO ST FL 6
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-7105
Mailing Address - Country:US
Mailing Address - Phone:312-926-8200
Mailing Address - Fax:
Practice Address - Street 1:446 E ONTARIO ST FL 6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-7105
Practice Address - Country:US
Practice Address - Phone:312-926-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016547363LP0808X
IL209.018327363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health