Individual
TYLER THAI DINH LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
707 LAKE COOK RD STE 280, DEERFIELD, IL 60015-5255
(847) 480-0004
(847) 480-8707
Mailing address
707 LAKE COOK RD STE 280, DEERFIELD, IL 60015-5255
(847) 480-0004
(847) 480-8707
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
085011055
IL
363A00000X
Physician Assistant
Primary
085011055
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/10/2024
Last updated
08/12/2026
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