Individual
DR. CARISSA TYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 802-2100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036112405
IL
207P00000X
Emergency Medicine Physician
Primary
83453
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100053775
—
WI
Enumeration date
08/01/2006
Last updated
05/06/2025
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