Individual
DR. TIMOTHY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-6000
Mailing address
1532 W THOMAS ST, APT 2R, CHICAGO, IL 60642-3969
(603) 986-5268
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125063255
IL
207RI0200X
Infectious Disease Physician
Primary
9774061-1204
UT
Other
Enumeration date
06/21/2013
Last updated
05/02/2023
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