Individual provider Active NPI

Michael Tyrkus, PH.D.

  • Clinical Medical Laboratory
  • Rockford, IL
National Provider Identifier
1043344526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
2400 North Rockton Ave.
Rockford Memorial Hospital
Rockford, IL 61103-3681
Phone
(815) 971-6701
Fax
(815) 961-1353
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2400 North Rockton Ave.
Rockford Memorial Hospital
Rockford, IL 61103-3681

Mailing address

2400 North Rockton Ave.
Rockford Memorial Hospital
Rockford, IL 61103-3681
Phone (815) 971-6701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043344526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NORTH ROCKTON AVE.",
            "address_2": "ROCKFORD MEMORIAL HOSPITAL",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033681",
            "telephone_number": "815-971-6701",
            "fax_number": "815-961-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NORTH ROCKTON AVE.",
            "address_2": "ROCKFORD MEMORIAL HOSPITAL",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033681",
            "telephone_number": "815-971-6701",
            "fax_number": "815-961-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYRKUS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.