Kiesewetter, Kyle D.

Kiesewetter, Kyle D. is an individual health care provider with primary practice located at 221 Ne Glen Oak Ave , Peoria IL 61636-0001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as his primary health care specialty. Kiesewetter, Kyle D. can be contacted via phone (309) 672-4859.

Contact Information

Primary practice address
221 Ne Glen Oak Ave Peoria IL 61636-0001
Phone: (309) 672-4859
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 364SG0600X 209.020932 Illinois

Profile Details

NPI number 1598399693
LBN Legal business name Kiesewetter, Kyle D.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2020
Last updated Feb 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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