Individual
TIMOTHY GRANT RAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61603-3133
(309) 655-2268
Mailing address
4207 W HOLLOW CREEK DR, PEORIA, IL 61615-5635
(765) 278-1323
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01064696A
IN
207P00000X
Emergency Medicine Physician
Primary
125-049400
IL
Other
Enumeration date
06/25/2007
Last updated
02/17/2022
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