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TYCO MEDICAL CLINIC LTD
NPI 1679708861
Internal Medicine in Chicago, IL

Active since May 18, 2009
2875 W 19TH ST, CHICAGO, IL 60623(773) 484-1000 Get Directions Write a Review

NPPES record last updated: May 18, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tyco Medical Clinic Ltd NPPES

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

TYCO MEDICAL CLINIC LTD (NPI 1679708861) is a healthcare organization registered as an internal medicine in Chicago, Illinois and active in the NPI registry since May 2009. The organization lists Tyla Courtney, President, as its authorized official.

NPPES Registry Identity

NPI1679708861
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameTYCO MEDICAL CLINIC LTD
Location Address2875 W 19TH STChicago, IL 60623-3501
Mailing Address2875 W 19th StChicago, IL 60623-3501 · (773) 484-1000
Phone(773) 484-1000
Organization SubpartNo
Authorized OfficialTyla CourtneyPresident · (773) 484-1000
Enumeration DateMay 18, 2009
✔ NPI 1679708861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036749530
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2875 W 19TH ST, Chicago, IL 60623
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyco Medical Clinic Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIllinoisEnrollment IDO20090615000300Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Tyco Medical Clinic Ltd, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tyla Courtney
Internal Medicine
NPI 1841329489
2875 W 19TH ST PHYSICIAN CENTER
Chicago, IL 60623
(773) 484-4425
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Tyco Medical Clinic Ltd's NPI number?

The NPI number for Tyco Medical Clinic Ltd is 1679708861. It was assigned to this organization in the NPPES registry on May 18, 2009.

Where is Tyco Medical Clinic Ltd located?

Tyco Medical Clinic Ltd is located at 2875 W 19th St, Chicago, IL 60623. The listed phone number is (773) 484-1000.

What is Tyco Medical Clinic Ltd's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Tyco Medical Clinic Ltd enrolled in Medicare?

Yes. Tyco Medical Clinic Ltd is registered in the Medicare PECOS enrollment system.

When is Tyco Medical Clinic Ltd's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Illinois, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Tyco Medical Clinic Ltd?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Tyco Medical Clinic Ltd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Tyco Medical Clinic Ltd was last updated on May 18, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.