Tyler, Jeffry A

Tyler, Jeffry A is an individual health care provider with primary practice located at 1200 Maple Rd Suite 3309, Joliet IL 60432-1439. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Tyler, Jeffry A can be contacted via phone (815) 723-9351.

Contact Information

Primary practice address
1200 Maple Rd Suite 3309 Joliet IL 60432-1439
Fax: (815) 723-9823
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036-075820 Illinois

Profile Details

NPI number 1386612679
LBN Legal business name Tyler, Jeffry A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2006
Last updated Jul 8th, 2007 - about 17 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 1386612679 NPPES
Illinois MEDICAID 036075820

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