Individual
STEPHANIE TYREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22285 N PEPPER RD STE 302, LAKE BARRINGTON, IL 60010-2541
(847) 726-0774
(847) 277-1549
Mailing address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.023861
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309017641
—
IL
01
—
MT6751324
DEA
IL
Enumeration date
08/21/2021
Last updated
01/10/2024
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