Provider Demographics
NPI:1639718653
Name:TIMMONS TYLER, APRIL (PHD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:
Last Name:TIMMONS TYLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:APRIL
Other - Middle Name:
Other - Last Name:TIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:6149 S WOODLAWN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-5911
Mailing Address - Country:US
Mailing Address - Phone:917-847-7501
Mailing Address - Fax:
Practice Address - Street 1:2600 S MICHIGAN AVE STE 405
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2696
Practice Address - Country:US
Practice Address - Phone:312-791-3463
Practice Address - Fax:312-791-3455
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009849103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical