Active NPI
Mary Tylke, PHARMD
- Pharmacist
- Milwaukee, WI
National Provider Identifier
1710185004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14111
- Practice address
- 3522 W Wisconsin Ave
Milwaukee, WI 53208-3846 - Phone
- (414) 342-4446
- NPI assigned
- Jul 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14111 | WI | Primary |
Addresses
Primary practice location
3522 W Wisconsin Ave
Milwaukee, WI 53208-3846
Mailing address
5441 S 48TH St
Greenfield, WI 53220-5014
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14111 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Milwaukee, WI
- NPI 1710994694
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- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710185004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5441 S 48TH ST",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532205014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3522 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083846",
"telephone_number": "414-342-4446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLKE",
"first_name": "MARY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "14111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.