Tyler Dahlke, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.13561 Issued in IL

Practice address

820 E Terra Cotta Ave Ste 253
Crystal Lake, IL 60014-3655

Phone

(224) 944-3973

NPI assigned

May 4, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Medicinal Chiropractic LLC

  • Chiropractor
  • Crystal Lake, IL
  • NPI 1548047038
  NPD Authorized official

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1396271789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE STE 253",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143655",
            "telephone_number": "224-944-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE STE 253",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143655",
            "telephone_number": "224-944-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLKE",
        "first_name": "TYLER",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.13561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.