Active NPI
Tyler Jack Sheets, LMT
- Massage Therapist
- Chicago, IL
National Provider Identifier
1093521940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.0187277
- Practice address
- 560 W Diversey Pkwy
Chicago, IL 60614-1678 - Phone
- (773) 524-6830
- NPI assigned
- Dec 5, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.0187277 | IL | Primary |
Addresses
Primary practice location
560 W Diversey Pkwy
Chicago, IL 60614-1678
Mailing address
65 E Scott St Apt 7L
Chicago, IL 60610-5272
Phone (989) 325-6435
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227.0187277 | IL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Wellness LLC | Past | Accepting new patients | |
| Active Wellness, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Chicago, IL
- NPI 1891120408
-
- Chiropractor
- Chicago, IL
- NPI 1902162662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1093521940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 E SCOTT ST APT 7L",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606105272",
"telephone_number": "989-325-6435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 W DIVERSEY PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606141678",
"telephone_number": "773-524-6830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEETS",
"first_name": "TYLER",
"middle_name": "JACK",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-12-05",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.0187277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.