Individual provider Active NPI

Tyler Chase Sylvester, M.S., ATC/L

  • Athletic Trainer
  • Evanston, IL
National Provider Identifier
1518419654
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096.004410 Issued in IL
Practice address
2255 Campus Dr
Evanston, IL 60208-1928
Phone
(904) 633-6565
NPI assigned
Oct 25, 2016
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096.004410 IL Primary

Addresses

Primary practice location

2255 Campus Dr
Evanston, IL 60208-1928

Mailing address

2255 Campus Dr
Evanston, IL 60208-1928

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
Master of Science

State licenses

LicenseStateTypeSpecialty
096.004410ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1518419654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 CAMPUS DR",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602081928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CAMPUS DR",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602081928",
            "telephone_number": "904-633-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYLVESTER",
        "first_name": "TYLER",
        "middle_name": "CHASE",
        "credential": "M.S., ATC/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.004410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.