Provider Demographics
NPI:1427483700
Name:BICKEL, TYLER ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:ANDREW
Last Name:BICKEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S STATE ST.
Mailing Address - Street 2:APT 2001
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3050
Mailing Address - Country:US
Mailing Address - Phone:303-518-1142
Mailing Address - Fax:
Practice Address - Street 1:1500 S. CALIFORNIA AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608
Practice Address - Country:US
Practice Address - Phone:773-542-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051296808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist