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Tyler Booth
NPI 1437643012 · on the registry since 2018
Practice
- Address
- 500 W Madison St Spc C024
Chicago, IL 60661 - Phone
- (312) 863-4900
- Fax
- (312) 863-4901
- Clinicians at this address
- 3
Additional practice sites
- 1909 N Morton Ave, Morton, IL
- 133 W Main St Ste 120, Northville, MI
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Also registered as
- 225100000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-05-07
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