Individual
DR. DAVID TYLICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2003014015
MO
208100000X
Physical Medicine & Rehabilitation Physician
Primary
45027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34679900
—
WI
Enumeration date
08/24/2006
Last updated
08/07/2024
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