Individual
DR. TIMOTHY J MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3915 OGLESBY AVE, SUITE 1, GURNEE, IL 60031-3358
(847) 336-1600
(847) 336-2380
Mailing address
1713 CENTRAL ST, EVANSTON, IL 60201-1507
(847) 869-1499
(847) 869-2932
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036050102
IL
207RI0011X
Interventional Cardiology Physician
Primary
036050102
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036050102
—
IL
Enumeration date
07/04/2006
Last updated
04/29/2021
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