Individual
MR. TIMOTHY R. HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 999-3201
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-001018
IL
Other
Enumeration date
09/20/2006
Last updated
07/18/2023
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