Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kody Gibson Bolk, MD

Individual provider Otolaryngology Physician · NPI 1669976023

Kody Gibson Bolk, MD is an Otolaryngology in Springfield, Illinois. Graduated from Southern Illinois University School of Medicine in 2018, 8 years ago. Practices with SIU Physicians and Surgeons Inc, a 316-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Georgia and Illinois.

Years since qualifying
8
Trained at
Southern Illinois University School of Medicine
Licensed in
GA, IL
In the registry since
2018
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

720 N Bond St
Springfield, IL 62702-4952
Phone: (217) 545-8000
Fax: (217) 545-6544
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 550 Peachtree St Ne Ste 1135, Atlanta, GA 30308-2234 — (404) 778-3381
  • 5000 Hennessy Blvd, Baton Rouge, LA 70808-4375 — (225) 765-6565
  • 533 Bolivar St Ste 566, New Orleans, LA 70112-1349 — (504) 568-4786

Specialties & licences

Otolaryngic Allergy Physician (primary) Taxonomy 207YX0602X · Licence 95460 (GA)
Otolaryngology Physician Taxonomy 207Y00000X · Licence 036.170483 (IL)
Otolaryngology Physician Taxonomy 207Y00000X · Licence 95460 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1669976023
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2018
Last updated in NPPESFebruary 12, 2026
Certification dateFebruary 12, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Siu Physicians And Surgeons Inc — 316 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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