Individual
TIM S. PROVIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 N SAINT CLAIR ST, GALTER 19-100, CHICAGO, IL 60611-5975
(312) 695-2458
(312) 695-0063
Mailing address
680 N LAKE SHORE DR, SUITE 1000, CHICAGO, IL 60611-4546
(312) 695-2458
(312) 695-0063
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
036129441
IL
Other
Enumeration date
07/01/2008
Last updated
03/25/2015
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