Provider Demographics
NPI:1336528835
Name:PYLE, TIA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:MARIE
Last Name:PYLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18425 W CREEK DR STE F
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6768
Mailing Address - Country:US
Mailing Address - Phone:708-444-8300
Mailing Address - Fax:
Practice Address - Street 1:18425 W CREEK DR STE F
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-6768
Practice Address - Country:US
Practice Address - Phone:708-444-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036149048207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology