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Individual

TIMOTHY O'CONNOR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2100 MADISON AVE, GRANITE CITY, IL 62040-4701
(660) 826-5960
(660) 826-4852
Mailing address
PO BOX 503734, SAINT LOUIS, MO 63150-0001
(660) 826-5960
(660) 826-4852

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209005367
IL

Other

Enumeration date
12/16/2005
Last updated
07/08/2007
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