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Search › Illinois › 101YP2500X

Tyler Stull, LCPC CADC

NPI 1407446636 · on the registry since 2021 · sole proprietor

Practice

Address
1200 W State St
Rockford, IL 61102
Phone
(815) 490-1600
Fax
(815) 490-1881
Organisation at this address
Walgreen Co
Laboratory Corporation Of America
Crusaders Central Clinic Association
Crusaders Central Clinic Association
Crusaders Central Clinic Association
Inferred from a shared address, not stated in the registry.
Clinicians at this address
173

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Also registered as
101YA0400X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-10-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois