Provider Demographics
NPI:1386901247
Name:DEMERS, TYLER DONALD (PSYD)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:DONALD
Last Name:DEMERS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 HALE AVE
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-1707
Mailing Address - Country:US
Mailing Address - Phone:251-223-1509
Mailing Address - Fax:
Practice Address - Street 1:17154 W HOFF RD
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IL
Practice Address - Zip Code:60421-9440
Practice Address - Country:US
Practice Address - Phone:815-478-4625
Practice Address - Fax:815-478-7832
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-17
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist