Individual
DR. TIMOTHY CHARLES SAMELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1425 N HUNT CLUB RD STE 204, GURNEE, IL 60031-2635
(847) 855-2997
(847) 855-8347
Mailing address
1425 N HUNT CLUB RD STE 204, GURNEE, IL 60031-2635
(847) 855-2997
(847) 855-8347
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-084135
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364050769-60031-01
—
IL
Enumeration date
07/27/2005
Last updated
12/08/2021
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