Individual
TIMOTHY MICHAEL DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2202 HARLEM RD, SUITE 200, LOVES PARK, IL 61111-2754
(815) 877-4848
Mailing address
8575 YELLOWSTONE DR, BYRON, IL 61010-9769
(815) 234-4185
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041327743
IL
163W00000X
Registered Nurse
197396-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
209014799
IL
Other
Enumeration date
08/11/2016
Last updated
02/22/2024
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