Individual provider Active NPI

Tyler Lee Watermann, DC

  • Chiropractor
  • Crystal Lake, IL
National Provider Identifier
1952281917
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-014320 Issued in IL
Practice address
10 North Virginia Street
Crystal Lake, IL 60014-4139
Phone
(815) 459-3860
Fax
(815) 459-3990
NPI assigned
Sep 2, 2025
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 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 038-014320 IL Primary

Addresses

Primary practice location

10 North Virginia Street
Crystal Lake, IL 60014-4139

Mailing address

10 North Virginia Street
Crystal Lake, IL 60014-4139
Phone (815) 459-3860

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223001893 IL Practitioner - Chiropractic 6002397668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 N Virginia St
Crystal Lake, IL 60014-4139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-014320ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Strelcheck Chiropractic Clinic LTD Chiropractor CurrentSince Feb 1, 2026 Accepting new patients

Locations

10 N Virginia St
Crystal Lake, IL 60014
Phone (815) 459-3860

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1952281917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NORTH VIRGINIA STREET",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144139",
            "telephone_number": "815-459-3860",
            "fax_number": "815-459-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NORTH VIRGINIA STREET",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144139",
            "telephone_number": "815-459-3860",
            "fax_number": "815-459-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMANN",
        "first_name": "TYLER",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-014320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

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