Provider Demographics
NPI:1629297999
Name:KAY, C. NEIL (BDS,MS)
Entity Type:Individual
Prefix:DR
First Name:C.
Middle Name:NEIL
Last Name:KAY
Suffix:
Gender:M
Credentials:BDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E DELAWARE PL
Mailing Address - Street 2:9108
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-1756
Mailing Address - Country:US
Mailing Address - Phone:630-567-2779
Mailing Address - Fax:630-896-9252
Practice Address - Street 1:25 BOULDER HILL PASS
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-1911
Practice Address - Country:US
Practice Address - Phone:630-896-2779
Practice Address - Fax:630-896-9252
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics