Provider Demographics
NPI:1043344526
Name:TYRKUS, MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:TYRKUS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 NORTH ROCKTON AVE.
Mailing Address - Street 2:ROCKFORD MEMORIAL HOSPITAL
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-3681
Mailing Address - Country:US
Mailing Address - Phone:815-971-6701
Mailing Address - Fax:815-961-1353
Practice Address - Street 1:2400 NORTH ROCKTON AVE.
Practice Address - Street 2:ROCKFORD MEMORIAL HOSPITAL
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-3681
Practice Address - Country:US
Practice Address - Phone:815-971-6701
Practice Address - Fax:815-961-1353
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory