Active NPI
Tyler Egbert
- Emergency Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036160308
- Practice address
- 635 N Dearborn St Ste 100
Chicago, IL 60654-4618 - Phone
- (312) 694-2127
- Fax
- (312) 694-2129
- NPI assigned
- Jun 13, 2018
- Last updated
- Nov 5, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036160308 | IL | Primary |
| Emergency Medicine Physician | 207P00000X | 2018018672 | MO |
Addresses
Primary practice location
635 N Dearborn St Ste 100
Chicago, IL 60654-4618
Mailing address
One Hospital Drive
Suite M562
Columbia, MO 65212
Phone (573) 884-3233
Other practice location 1
One Hospital Drive
Suite M562
Columbia, MO 65212
Phone (573) 884-3233
Other practice location 2
200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-7762
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tyler.egbert.1@15486.direct.athenahealth.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822
200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841
635 N Dearborn St
Chicago, IL 60654-4618
Phone (312) 926-0404
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Statera Health Care, LLC | Emergency Medicine | Current | Accepting new patients |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Morrison Community Hospital District | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Southeastern Emergency Physicians of Memphis LLC | Emergency Medicine | Current | Accepting new patients |
| Southeast Missouri Hospital Physicians, LLC | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Iroquois Memorial Hospital and Resident Home | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Central Dupage Physician Group | Past | Accepting new patients | |
| Rockford Health Physicians | Past | Accepting new patients | |
| Iroquois Memorial Hospital and Resident Home | Past | Accepting new patients | |
| CGH Medical Center | Past | Accepting new patients |
Locations
2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691
Dept 5777
Carol Stream, IL 60122
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
611 S Marshall Ave
Mc Leansboro, IL 62859
Phone (618) 542-2146
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003
200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201
1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000
1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
3400 Deerfield Dr
Janesville, WI 53546
Phone (608) 314-3600
Interoperability endpoints
- tyler.egbert.1@15486.direct.athenahealth.com
Organizations & group practices 14
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.
-
dba Northwestern Medical Group
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Emergency Medicine Physician
- Harrisburg, IL
- NPI 1043874449
-
dba MHS Physician Services
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
dba Mercy Clinic Southeast
- Family Medicine Physician
- Cape Girardeau, MO
- NPI 1558311522
-
- Critical Access Hospital
- Watseka, IL
- NPI 1629003470
-
- Critical Access Hospital
- Morrison, IL
- NPI 1184844938
-
- Emergency Medicine Physician
- Alton, IL
- NPI 1437105277
MO
-
dba Northwestern Medical Group
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
dba Mercy Hospital Janesville
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
dba Mercy Walworth Hospital and Medical Center
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
- General Acute Care Hospital
- Sterling, IL
- NPI 1902854623
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Watseka, IL
- NPI 1629003470
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
-
dba Mercy Hospital Janesville
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
dba Mercy Hospital Southeast
- General Acute Care Hospital
- Cape Girardeau, MO
- NPI 1811006661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1801389853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE HOSPITAL DRIVE",
"address_2": "SUITE M562",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65212",
"telephone_number": "573-884-3233",
"fax_number": "573-884-5994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 N DEARBORN ST STE 100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606544618",
"telephone_number": "312-694-2127",
"fax_number": "312-694-2129"
}
],
"practiceLocations": [
{
"address_1": "One Hospital Drive",
"address_2": "Suite M562",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "65212",
"country_code": "US",
"telephone_number": "573-884-3233",
"fax_number": "573-884-5994",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 E Fairman Ave",
"address_purpose": "LOCATION",
"city": "Watseka",
"state": "IL",
"postal_code": "609701644",
"country_code": "US",
"telephone_number": "815-432-7762",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EGBERT",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-13",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036160308",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2018018672",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tyler.egbert.1@15486.direct.athenahealth.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "200 E Fairman Ave",
"city": "Watseka",
"state": "IL",
"country_code": "US",
"postal_code": "609701644",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.