Individual
TIMOTHY P WOMBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(708) 783-7025
(708) 783-7409
Mailing address
11970 N CENTRAL EXPY STE 210, DALLAS, TX 75243-3784
(214) 575-5885
(907) 782-4662
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12692
TX
363AS0400X
Surgical Physician Assistant
085005389
IL
Other
Enumeration date
05/14/2012
Last updated
08/28/2023
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