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TYLER DAVID AGNEW
NPI 1598239808
Family Medicine in Great Lakes, IL

Active since January 20, 2019PECOS Enrolled
3420 ILLINOIS ST, GREAT LAKES, IL 60088(847) 688-6577 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 4, 2025, Jan 20, 2019 (2 updates tracked since 2019).

About Tyler David Agnew NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER DAVID AGNEW (NPI 1598239808) is an individual family medicine provider in Great Lakes, Illinois, licensed in Virginia (0101270164) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1598239808
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTYLER DAVID AGNEW
Location Address3420 ILLINOIS STGreat Lakes, IL 60088-3161
Mailing Address3420 Illinois StGreat Lakes, IL 60088-3161 · (847) 688-6577
Phone(847) 688-6577
Sole ProprietorNo
Enumeration DateJanuary 20, 2019
Last NPPES UpdateFebruary 4, 20252 updates tracked since enumeration
NPPES CertifiedFebruary 4, 2025
✔ NPI 1598239808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in VA · 0101270164
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 0101270164 (VA)
3420 ILLINOIS ST, Great Lakes, IL 60088
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyler David Agnew is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60088 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY J BAKER DPT
Physical Therapist
3420 ILLINOIS ST
GREAT LAKES, IL 60088
Lake County (847) 688-6755
MR. WARREN K KENNEDY PA-C
Physician Assistant (Medical)
3420 ILLINOIS ST
GREAT LAKES, IL 60088
Lake County (847) 688-2522
TOMASZ BOLTRUCZYK FNP-C
Nurse Practitioner (Family)
3420 ILLINOIS ST
GREAT LAKES, IL 60088
Lake County (847) 688-5568
MR. WILLIAM HARRELD PETERSON PA-C
Physician Assistant
3420 ILLINOIS ST, USS TRANQUILITY MEDICAL CLINIC 1007
GREAT LAKES, IL 60088
Lake County (847) 688-6755
DR. JASON YUNGSUP KIM MD
Family Medicine
3420 ILLINOIS ST, USS TRANQUILLITY CLINIC 1007
GREAT LAKES, IL 60088
Lake County (847) 688-6755
JAMES A LOVELL FHCC
Military/U.S. Coast Guard Pharmacy
3420 ILLINOIS ST, USS TRANQUILITYAH14 MED CLN 1017
GREAT LAKES, IL 60088
Lake County (847) 688-2100
DR. NEMESIA FIGUERAS ARTATES M.D.
General Practice
3420 ILLINOIS ST
GREAT LAKES, IL 60088
Lake County (847) 688-6755
DR. JOHN E. DALTON PH.D.
Psychologist (Clinical)
3420 ILLINOIS ST, REU, BUILDING 1007
GREAT LAKES, IL 60088
Lake County (847) 688-7406

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Agnew's NPI number?

The NPI number for Tyler Agnew is 1598239808. It was assigned to this individual provider in the NPPES registry on January 20, 2019.

Where is Tyler Agnew located?

Tyler Agnew practices at 3420 Illinois St, Great Lakes, IL 60088. The listed phone number is (847) 688-6577.

What is Tyler Agnew's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Tyler Agnew enrolled in Medicare?

Yes. Tyler Agnew is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tyler Agnew was last updated on February 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.