Individual
TYLER DAVIS-SANDFOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-0454
Mailing address
3218 N CLARK ST APT 410, CHICAGO, IL 60657-0021
(859) 866-4479
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
041.471617
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209018741
IL
Other
Enumeration date
11/15/2018
Last updated
03/22/2019
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