Tyler Wishau
Tyler Wishau is a Podiatry in Mount Vernon, Illinois. Qualified in 2014, 12 years ago. Practices with Physician Services Corporation of Southern Illinois Inc, a 122-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.
- Years since qualifying
- 12
- Licensed in
- IL
- In the registry since
- 2014
- Specialties on file
- 2
Practice location Address checks out
2 Good Samaritan Way Ste 420Mount Vernon, IL 62864-2478
Phone: (618) 899-3900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 12303 Depaul Dr., Bridgeton, MO 63044-2588 — (314) 344-6000
Specialties & licences
| Foot & Ankle Surgery Podiatrist (primary) | Taxonomy 213ES0103X · Licence 016005806 (IL) |
|---|---|
| Podiatrist | Taxonomy 213E00000X · Licence 016005806 (IL) |
Record details
| NPI number | 1144649856 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 9, 2014 |
| Last updated in NPPES | February 22, 2022 |
| Certification date | February 22, 2022 |
| Mailing address | Po Box 955860, Saint Louis, MO 63195-2588 |
Medicare enrollment
| Medicare specialty | PODIATRY |
|---|---|
| Medical school | OTHER |
| Graduated | 2014 (12 years in practice) |
| Group practice | Physician Services Corporation Of Southern Illinois Inc — 122 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Mount Vernon
-
S Thomas Sehy DPM LLC
209 Crossroads Pl Ste 130, Mount Vernon, IL 62864-6545 · (314) 241-9411