Search › Illinois › 1041C0700X
Tyler Goodwine, LCSW
NPI 1992148548 · on the registry since 2013 · sole proprietor
Practice
- Address
- 7646 N Waukegan Rd
Niles, IL 60714 - Phone
- (773) 294-6403
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2013-04-14
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