Individual
TIMOTHY W SWAIN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 TEXAN TRL, 301, CORPUS CHRISTI, TX 78411-2547
(484) 614-4759
Mailing address
5405 N KNOXVILLE AVE, PEORIA, IL 61614-5016
(309) 691-4410
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01084422A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036-117825
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117825
—
IL
Enumeration date
08/03/2006
Last updated
08/24/2023
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