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Contact Information

TYSON EVERETT, CSAC
5500 S INDIANA AVE BSMT
CHICAGO, IL60637-1011
 Phone: 773-488-9460
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
Indicates primary specialty

NPI Profile & details for TYSON EVERETT · (Male)

NPI # 1255717385
Status Active
Credentials CSAC
Entity Individual
Enumeration date 07/30/2015
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Yes
Identifiers
  • IL License # A-3249-0001
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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