Tyco Medical Clinic LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036749530 Issued in IL

Legal business name

TYCO MEDICAL CLINIC LTD

Practice address

2875 W 19TH St
Chicago, IL 60623-3501

Phone

(773) 484-1000

NPI assigned

May 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Tyla Courtney, MDNPI 1841329489

Title

President

Phone

(773) 484-1000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyla Courtney

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1841329489
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242604800000",
    "number": "1679708861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-484-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-484-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYCO MEDICAL CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "last_updated": "2009-05-18",
        "status": "A",
        "authorized_official_last_name": "COURTNEY",
        "authorized_official_first_name": "TYLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-484-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036749530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Two Hands Chiropractic and Acupuncture, LLC
• Kelly Twohig
• Anna Tworzyanski, RD, LDN
• Clarissa Caballes Ty, PT
• Ravi Tyagi, MD
• Caroline Kelly Tye, LCPC, ATR-BC
• Albina Tyker, MD
• Aneesh Tyle, MD
• Deangelo Vancetrice Tyler
• Debbie Tyler, NP

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.