Healthcare Provider Details

I. General information

NPI: 1386901247
Provider Name (Legal Business Name): TYLER DONALD DEMERS PSY.D, LP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2012
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17154 W HOFF RD
ELWOOD IL
60421-9440
US

IV. Provider business mailing address

345 HALE AVE
ROMEOVILLE IL
60446-1707
US

V. Phone/Fax

Practice location:
  • Phone: 815-478-4625
  • Fax: 815-478-7832
Mailing address:
  • Phone: 251-223-1509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.009989
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: