Individual
DR. MICHAEL TIMINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 S GREENLEAF ST STE 401, GURNEE, IL 60031-5709
(314) 238-5260
(314) 821-1833
Mailing address
PO BOX 772555, DETROIT, MI 48277-2555
(314) 238-5260
(314) 821-1833
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
32158
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000136V
HUMANA
—
05
—
036078979
—
IL
05
—
1851342505
—
WI
01
—
300040353
RAILROAD MEDICARE
—
Enumeration date
05/15/2006
Last updated
08/09/2022
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