Individual
DR. TIMOTHY RAYMOND LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1725 W HARRISON ST STE 1159, CHICAGO, IL 60612
(312) 942-5020
Mailing address
1725 W HARRISON ST STE 1159, CHICAGO, IL 60612-3883
(312) 942-5020
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036-149085
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036-149085
IL
Other
Enumeration date
05/11/2011
Last updated
07/23/2019
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