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

Kyle Petty, MD

Individual provider Anesthesiology Physician · NPI 1104310630

Kyle Petty, MD is an Anesthesiology in Evanston, Illinois. Qualified in 2018, 8 years ago. Practices with Endeavor Health Medical Group, a 3,348-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Licensed in
IL
In the registry since
2018
Specialties on file
2
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

2650 Ridge Ave Dept OF Anesthesia
Evanston, IL 60201
Phone: (847) 570-2760
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5841 S Maryland Ave, Chicago, IL 60637-1443 — (773) 702-6842

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 036159935 (IL)
Anesthesiology Physician Taxonomy 207L00000X · Licence 125.072135 (IL)

Record details

NPI number1104310630
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 18, 2018
Last updated in NPPESDecember 28, 2022
Certification dateDecember 27, 2022
Mailing address2650 Ridge Ave., Dept. Of Anesthesiology, Evanston, IL 60201

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Endeavor Health Medical Group — 3348 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations11 on file with Medicare

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