Pena, Tyler

Pena, Tyler is an sole proprietor health care provider with primary practice located at 10537 S Roberts Rd , Palos Hills IL 60465-1933. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Pena, Tyler can be contacted via phone (708) 974-2300.

Contact Information

Primary practice address
10537 S Roberts Rd Palos Hills IL 60465-1933
Phone: (708) 974-2300
Fax: (708) 974-2498
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 180014127 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Illinois

Profile Details

NPI number 1518457365
LBN Legal business name Pena, Tyler
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2018
Last updated Mar 19th, 2024 - about 9 months 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 1518457365 NPPES
Illinois MEDICAID 36216-7940

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