Organization
TANDEM PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER FORTMAN (OWNER)
(614) 273-5372
Entity
Organization
Contact information
Practice address
3354 N PAULINA ST, 205, CHICAGO, IL 60657-1068
(773) 273-9719
Mailing address
3354 N PAULINA ST, 205, CHICAGO, IL 60657-1068
(773) 273-9719
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008865
IL
Other
Enumeration date
06/24/2016
Last updated
02/14/2017
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