Individual
TYLER J MCCAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1135 W 69TH ST, CHICAGO, IL 60621-1147
(773) 483-5011
Mailing address
1135 W 69TH ST, CHICAGO, IL 60621-1147
(773) 483-5011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-007108
IL
363AM0700X
Medical Physician Assistant
085.007108
IL
Other
Enumeration date
06/17/2019
Last updated
04/27/2021
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