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

Tyler Wayne Wilson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1154998110

Tyler Wayne Wilson is a Student in an Organized Health Care Education/Training Program in Chicago, Illinois. Licensed in Illinois and Utah. Registered with an NPI since 2021.

Licensed in
IL, UT
In the registry since
2021
Specialties on file
2

Practice location Address checks out

5841 S Maryland Ave # MC6040
Chicago, IL 60637-1443
Phone: (773) 702-6337
Show map & directions

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

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 125.081735 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (UT)

Record details

NPI number1154998110
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 8, 2021
Last updated in NPPESMay 11, 2023
Certification dateMay 11, 2023
Mailing address180 Harvester Dr Ste 110, Burr Ridge, IL 60527-6686

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