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

Tyler David Agnew

Individual provider General Practice Physician · NPI 1598239808

Tyler David Agnew is a General Practice Physician in Great Lakes, Illinois. Licensed in Virginia. Registered with an NPI since 2019.

Licensed in
VA
In the registry since
2019
Specialties on file
2

Practice location Address checks out

3420 Illinois St
Great Lakes, IL 60088-3161
Phone: (847) 688-6577
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0101270164 (VA)
General Practice Physician Taxonomy 208D00000X · Licence 0101270164 (VA)

Record details

NPI number1598239808
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 20, 2019
Last updated in NPPESFebruary 4, 2025
Certification dateFebruary 4, 2025
Mailing address3420 Illinois St, Great Lakes, IL 60088-3161

Other providers in Great Lakes