Provider Demographics
NPI:1841301413
Name:SATISKY, KEVIN FRANKLIN (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:FRANKLIN
Last Name:SATISKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 WINDISH DR
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-9780
Mailing Address - Country:US
Mailing Address - Phone:309-344-4200
Mailing Address - Fax:
Practice Address - Street 1:2323 WINDISH DR
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-9780
Practice Address - Country:US
Practice Address - Phone:269-352-3906
Practice Address - Fax:269-352-3906
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-1160282084A0401X, 2084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336-077057OtherCONTROLLED SUBSTANCE
IL036-116028Medicaid
IL370984175OtherBWAY INC FEIN
IL036-116028OtherMD LICENSE
IL336-077057OtherCONTROLLED SUBSTANCE
IL370984175OtherBWAY INC FEIN
BS9787081OtherDEA CONTROLL NUMBER