Tyler J Pullen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

117 S 6TH Ave
Maywood, IL 60153-1305

Phone

(708) 681-4357

NPI assigned

May 18, 2022

Last updated

Jan 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Presence Behavioral Health

  dba ProCare Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Melrose Park, IL
  • NPI 1477622298
  NPD (past)

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1215674403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E COMSTOCK AVE",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601014835",
            "telephone_number": "630-833-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S 6TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601531305",
            "telephone_number": "708-681-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Walnut St Ste B",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "IL",
            "postal_code": "601742766",
            "country_code": "US",
            "telephone_number": "877-504-4141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1414 Main St",
            "address_purpose": "LOCATION",
            "city": "Melrose Park",
            "state": "IL",
            "postal_code": "601603902",
            "country_code": "US",
            "telephone_number": "708-681-4357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3436 N Kennicott Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600047814",
            "country_code": "US",
            "telephone_number": "847-952-7460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "TYLER",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proviso-Leyden Council for Community Action Inc
• Provison TWP HS Dist 209
• Brooke Prysi
• Patrick Przybylo, DO
• Abigail Puckett
• Crystal Pun
• Imran M. Puthawala, M.D.
• Amani Qasem, M.D.
• Saim M Qazi, MD
• Sameer Qazi

• Mental Health Counselor in Maywood, IL
• Providers in Maywood, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.