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TIMOTHY JAMES SAMOLITIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
8600 N. STATE ROUTE 91, SUITE 250, PEORIA, IL 61615
(309) 692-5394
(309) 692-2538
Mailing address
8600 N. STATE ROUTE 91, SUITE 250, PEORIA, IL 61615
(309) 692-5394
(309) 692-2538

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209005907
IL
367500000X
Certified Registered Nurse Anesthetist
R143228
MD

Other

Enumeration date
10/04/2005
Last updated
06/13/2019
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