Healthcare Provider Details

I. General information

NPI: 1821901430
Provider Name (Legal Business Name): MICHAEL TYLER BIGGS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 CHURCH ST STE 302
EVANSTON IL
60201-5912
US

IV. Provider business mailing address

848 W LAKESIDE PL APT 2R
CHICAGO IL
60640-6649
US

V. Phone/Fax

Practice location:
  • Phone: 847-492-1938
  • Fax:
Mailing address:
  • Phone: 765-421-4767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: