Individual
TIMOTHY JOHN LAURIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
825 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3218
(847) 362-1393
(847) 367-1480
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036114072
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
362169147
EMPLYOR I.D. NUMBER
IL
Enumeration date
08/06/2008
Last updated
01/20/2023
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