Individual
DEREK TIMMERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5666 E STATE ST, EMERGENCY DEPARTMENT, ROCKFORD, IL 61108-2425
(815) 395-5189
Mailing address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 395-5189
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.118970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WA91176B
—
CA
Enumeration date
06/13/2006
Last updated
08/31/2012
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