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General NPI Number Information
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NPI Number | 1639718653
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Entity Type | Individual
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Provider Name | APRIL TIMMONS TYLER PHD
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Gender | Female
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Dates
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Enumeration Date | 12/23/2019
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 2600 S MICHIGAN AVE STE 405
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City | CHICAGO
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State | IL
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Zip | 60616-2696
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Country | US
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Telephone | 312-791-3463
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Fax | 312-791-3455
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Provider Business Mailing Address
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Address Line | 6149 S WOODLAWN AVE APT 2
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City | CHICAGO
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State | IL
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Zip | 60637-5911
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Country | US
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Telephone | 917-847-7501
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.009849
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License Number State | IL
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