Individual
TIMOTHY CO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 W LAKE ST, NORTHLAKE, IL 60164-2435
(847) 644-9714
Mailing address
1288 PERRY ST APT 11, DES PLAINES, IL 60016-3359
(847) 644-9714
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007830
IL
Other
Enumeration date
09/15/2017
Last updated
01/16/2019
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