Tyler Doersam (NPI# 1417365123, PAC ID# 8022300888) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1417365123 |
| PAC ID by PECOS | 8022300888 |
| Professional Enrollment ID | I20160714001690 |
| Full Name | Tyler Doersam |
| Organization Legal Name | LIFETIME VISION AND CONTACT LENS CENTER LTD |
| Address |
300 Memorial Dr Suite 300 Crystal Lake IL 60014-6273 |
| Phone Number | 8154597110 |
| Gender | M |
| Medical School | PENNSYLVANIA COLLEGE OF OPTOMETRY |
| Graduation Year | 2014 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 1557421757 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 300 Memorial Dr, Suite 300, Crystal Lake, IL 60014-6273 | 8154597110 | LIFETIME VISION AND CONTACT LENS CENTER LTD |
| Organization Legal Name | LIFETIME VISION AND CONTACT LENS CENTER LTD |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaitlyn S Keller | Optometry | Lifetime Vision and Contact Lens Center Ltd | 300 Memorial Dr, Suite 300, Crystal Lake, IL 60014-6273 |
| Lamont M Sprague | Optometry | Lifetime Vision and Contact Lens Center Ltd | 300 Memorial Dr, Suite 300, Crystal Lake, IL 60014-6273 |
| Street Address |
300 MEMORIAL DR SUITE 300 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip | 60014-6273 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Janet N Myers | Clinical Social Worker | Myers Counseling Group, Ltd | 300 Memorial Dr, Suite 200, Crystal Lake, IL 60014-6273 |
| Mark A Myers | Clinical Social Worker | Myers Counseling Group, Ltd | 300 Memorial Dr, Suite 200, Crystal Lake, IL 60014-6273 |
| Kaitlyn S Keller | Optometry | Lifetime Vision and Contact Lens Center Ltd | 300 Memorial Dr, Suite 300, Crystal Lake, IL 60014-6273 |
| Lamont M Sprague | Optometry | Lifetime Vision and Contact Lens Center Ltd | 300 Memorial Dr, Suite 300, Crystal Lake, IL 60014-6273 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Socha | Chiropractic | 435 Angela Ln, Suite 19, Crystal Lake, IL 60014-1074 | |
| Mark D Lagerkvist | Chiropractic | Chiro One Wellness Center of Crystal Lake Sc | 435 Angela Ln, Suite 19, Crystal Lake, IL 60014-1074 |
| Michael T Burns | Psychologist, Clinical | 610 Crystal Point Dr, Suite 3, Crystal Lake, IL 60014-1400 | |
| Kenneth E Heinrichs | Psychologist, Clinical | 755 E Mcardle Dr, Suite E, Crystal Lake, IL 60014-1717 | |
| Katherine A Galias | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Susan G Swanson | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Christy A Benton | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Roseann C Iverson | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Cynthia G Macdonald | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Michael S Lesser | Family Medicine | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Find all physicians in zip 60014 | |||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
| Specialty | OPTOMETRY |
| City + Specialty | CRYSTAL LAKE + OPTOMETRY |
Please comment or provide details below to improve the information on Tyler Doersam.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.