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Individual

DR. TYLER HUMPHREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5375
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036152059
IL
207P00000X
Emergency Medicine Physician
125070440
IL
207P00000X
Emergency Medicine Physician
Primary
4301504433
MI

Other

Enumeration date
05/25/2017
Last updated
06/27/2022
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