Anderson, Tyrone

Anderson, Tyrone is an individual health care provider with primary practice located at 5910 W Division St , Chicago IL 60651-1031. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Anderson, Tyrone can be contacted via phone (773) 777-7112.

Contact Information

Primary practice address
5910 W Division St Chicago IL 60651-1031
Phone: (773) 777-7112
Fax: (773) 887-3300
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11457 Illinois

Profile Details

NPI number 1326536376
LBN Legal business name Anderson, Tyrone
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2018
Last updated Apr 25th, 2018 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1326536376 NPPES
Illinois MEDICAID 36-3297629

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