Individual
DR. TYLER DOERSAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
118 LAKESIDE DR, APT 434, SAINT CHARLES, IL 60174-7905
(815) 821-3088
Mailing address
20505 RAND RD, STE 500, KILDEER, IL 60047-3004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010839
IL
Other
Enumeration date
07/25/2014
Last updated
03/11/2016
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