Provider Demographics
NPI:1689817371
Name:JAMES, MARYELIZABETH TYLER (MD)
Entity type:Individual
Prefix:DR
First Name:MARYELIZABETH
Middle Name:TYLER
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARYELIZABETH
Other - Middle Name:TYLER
Other - Last Name:RASHID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 N WILLIAM KUMPF BLVD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61605-2507
Mailing Address - Country:US
Mailing Address - Phone:309-676-5546
Mailing Address - Fax:309-676-5045
Practice Address - Street 1:303 N WILLIAM KUMPF BLVD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61605-2507
Practice Address - Country:US
Practice Address - Phone:309-676-5546
Practice Address - Fax:309-676-5045
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-11
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361287942086S0105X, 174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No174400000XOther Service ProvidersSpecialist