Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KODY GIBSON BOLK, MD
ActiveKODY GIBSON BOLK, MD is a Otology & Neurotology healthcare provider located in SPRINGFIELD, Illinois. NPI 1669976023 is currently active in the NPPES registry. Verify at CMS.
Otology & Neurotology · SPRINGFIELD, IL
Registration Details
- NPI Number
- 1669976023
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 21, 2018 (8.4348794420425 yrs)
- Last Updated
- Feb 12, 2026
- Licenses
-
036.170483 (IL)95460 (GA)95460 (GA)
Practice Information
- Address
-
720 N BOND STSPRINGFIELD, IL, 627024952Browse IL providers · Browse ZIP 62702
- Phone
- 2175458000
- Fax
- 2175456544
- Primary Specialty
-
Otology & Neurotology
207YX0602X
- Additional Specialty
- Otology & Neurotology
- Additional Specialty
- Otolaryngology
- Additional Specialty
- Student (Health Education/Training)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.