Individual
TIMOTHY JAMES KINSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2868
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.003829
IL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1091098
NCCPA
IL
Enumeration date
06/28/2010
Last updated
10/21/2019
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