Individual
DR. TIMOTHY A KISLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1870 SILVER CROSS BLVD, SUITE 110, NEW LENOX, IL 60451-8639
(815) 485-2727
(815) 485-3034
Mailing address
1870 SILVER CROSS BLVD, SUITE 110, NEW LENOX, IL 60451-8639
(815) 485-2727
(815) 485-3034
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036097974
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097974
—
IL
01
—
P00061462
RAILROAD MEDICARE
IL
Enumeration date
06/08/2005
Last updated
07/31/2023
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