Individual
DR. TYLER JOEL MINNICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7610 ROOSEVELT RD, FOREST PARK, IL 60130-2295
(708) 366-9278
Mailing address
17W726 BUTTERFIELD RD APT 208, OAKBROOK TERRACE, IL 60181-4228
(574) 238-6061
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011753
IL
207W00000X
Ophthalmology Physician
046.011753
IL
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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