Individual
TIMOTHY HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3156
Mailing address
PO BOX 955277, SAINT LOUIS, MO 63195-5277
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360922652
—
IL
Enumeration date
06/15/2006
Last updated
07/12/2007
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