Individual
TYSON EVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
5500 S INDIANA AVE BSMT, CHICAGO, IL 60637-1011
(773) 488-9460
Mailing address
5500 S INDIANA AVE BSMT, CHICAGO, IL 60637-1011
(773) 488-9460
(773) 488-9462
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
A-3249-0001
IL
Other
Enumeration date
07/30/2015
Last updated
09/11/2025
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