TYLER PATRICK DOUGAN (APN-CRNA) – Certified Registered Nurse Anesthetist, NPI 1104545631

TYLER PATRICK DOUGAN (APN-CRNA) is a healthcare provider. based in North chicago, Illinois. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials APN-CRNA. They hold a License No. 259056 (WI). The NPI Number for TYLER PATRICK DOUGAN (APN-CRNA) is 1104545631

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
TYLER PATRICK DOUGAN (APN-CRNA)
NPI
1104545631
Phone
(779) 212-2058
Address
3333 GREEN BAY RD
Enumeration Date
26 August 2022
Last Update Date
16 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7739891606
Graduation Year
2024 (2 years ago)
PAC ID
1658817820
Group Practice PAC ID
2163334699
Professional Enrollment ID
I20240724000640
Address ID
IL606253661CH5145XAVEX405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:3State licenses:2Digital endpointsOther names

2,265 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IL

Provider Addresses for TYLER PATRICK DOUGAN (APN-CRNA)

  • 3333 GREEN BAY RD

    NORTH CHICAGO, IL 600643037

    Phone: (779) 212-2058

    Type: Mailing

  • 2650 RIDGE AVE.

    DEPARTMENT OF ANESTHESIA

    EVANSTON, IL 602011718

    Phone: (847) 570-2760

    Fax: (847) 570-2921

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240724000640ICertified Registered Nurse Anesthetist (Crna)ILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60064)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163334699View full group profile
NameSpecialtyState
-IL
E N D O C R I N O L O G YIL
N E U R O L O G YIL
Hospitalist, Internal MedicineIL
O P H T H A L M O L O G YIL
-IL
E N D O C R I N O L O G YIL
Cardiovascular Disease (Cardiology), Interventional CardiologyIL
Clinical Social WorkerIL
Certified Nurse Midwife (Cnm)IL

Reviews

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Frequently asked questions

What number should I use to identify TYLER PATRICK DOUGAN (APN-CRNA) for billing?
Administrative and clinical systems typically use NPI 1104545631 for TYLER PATRICK DOUGAN (APN-CRNA).
Quick check: is TYLER PATRICK DOUGAN (APN-CRNA) active?
Public NPPES data shows TYLER PATRICK DOUGAN (APN-CRNA) with an active NPI status right now.
What type of care does TYLER PATRICK DOUGAN (APN-CRNA) provide?
TYLER PATRICK DOUGAN (APN-CRNA)'s profile centers on Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Which community is linked to TYLER PATRICK DOUGAN (APN-CRNA)?
TYLER PATRICK DOUGAN (APN-CRNA) shows a connection to North Chicago, Illinois in registry-derived data.
Who maintains TYLER PATRICK DOUGAN (APN-CRNA)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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