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

Individual provider Diagnostic Radiology Physician · NPI 1477529626

Kyle Kallenbach, MD is a Diagnostic Radiology in Glen Ellyn, Illinois. Graduated from Rush Medical College of Rush University in 1996, 30 years ago. Practices with The South Bend Clinic LLC, a 170-clinician group. Licensed in Illinois.

Years since qualifying
30
Trained at
Rush Medical College of Rush University
Licensed in
IL
In the registry since
2006
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

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone: (630) 469-9200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 036105204 (IL)

Record details

NPI number1477529626
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 27, 2006
Last updated in NPPESAugust 9, 2023
Certification dateAugust 9, 2023
Mailing addressPo Box 713260, Chicago, IL 60677-1260

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolRUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated 1996 (30 years in practice)
Group practice The South Bend Clinic Llc — 170 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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