Healthcare Provider Details

I. General information

NPI: 1801699475
Provider Name (Legal Business Name): TYE L BORLAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N OAK ST
HINSDALE IL
60521-3829
US

IV. Provider business mailing address

903 COMMERCE DR STE 333
OAK BROOK IL
60523-8723
US

V. Phone/Fax

Practice location:
  • Phone: 630-856-9000
  • Fax:
Mailing address:
  • Phone: 630-312-7755
  • Fax: 630-856-9933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209032050
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: