Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Tyler Doersam, OD

Individual provider Optometrist · NPI 1417365123

Dr. Tyler Doersam, OD is an Optometry in Saint Charles, Illinois. Graduated from Pennsylvania College of Optometry in 2014, 12 years ago. Practices with Tyler Ridge Vision Care, Ltd, a 4-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Trained at
Pennsylvania College of Optometry
Licensed in
IL
In the registry since
2014
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

118 Lakeside Dr Apt 434
Saint Charles, IL 60174-7905
Phone: (815) 821-3088
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 046010839 (IL)

Record details

NPI number1417365123
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJuly 25, 2014
Last updated in NPPESMarch 11, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolPENNSYLVANIA COLLEGE OF OPTOMETRY
Graduated 2014 (12 years in practice)
Group practice Tyler Ridge Vision Care, Ltd — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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