Individual
DR. TIMOTHY JOHN MIKESELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1775 BALLARD RD, PARK RIDGE, IL 60068-1005
(847) 318-2400
(847) 318-2558
Mailing address
1230 W MELROSE ST, CHICAGO, IL 60657-3218
(773) 348-4333
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036102613
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102613
—
IL
Enumeration date
06/21/2006
Last updated
12/17/2021
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