Individual
THEODORE TIMOTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-6700
Mailing address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-6700
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.156060
IL
Other
Enumeration date
03/23/2017
Last updated
02/11/2022
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