Individual
MR. TYLER WURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
3939 N MOZART ST, CHICAGO, IL 60618-3619
(773) 574-9758
Mailing address
3939 N MOZART ST, CHICAGO, IL 60618-3619
(773) 574-9758
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180008559
IL
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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