Individual provider Active NPI

Tyler Robert Yungck, D C

  • Chiropractor
  • Edwardsville, IL
National Provider Identifier
1548769425
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013182 Issued in IL
Practice address
1011 Century Dr
Edwardsville, IL 62025-3772
Phone
(618) 650-9303
NPI assigned
Feb 6, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013182 IL Primary

Addresses

Primary practice location

1011 Century Dr
Edwardsville, IL 62025-3772

Mailing address

1011 Century Dr
Edwardsville, IL 62025-3772
Phone (618) 420-9051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219000057 IL Practitioner - Chiropractic 7315282464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1011 Century Dr
Edwardsville, IL 62025-3772
Phone (618) 650-9303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013182ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tiger Chiropractic Inc. Chiropractor CurrentSince Jan 5, 2019 Accepting new patients

Locations

1011 Century Dr
Edwardsville, IL 62025
Phone (618) 420-9051

203 E Ferguson Ave
Wood River, IL 62095
Phone (618) 254-2273

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1548769425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 CENTURY DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253772",
            "telephone_number": "618-420-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 CENTURY DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253772",
            "telephone_number": "618-650-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUNGCK",
        "first_name": "TYLER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D  C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-06",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.