Kennedy, Timothy J

Kennedy, Timothy J is an individual health care provider with primary practice located at 1712 15Th Street Pl , Moline IL 61265-3961. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Kennedy, Timothy J can be contacted via phone (309) 797-5700.

Contact Information

Primary practice address
1712 15Th Street Pl Moline IL 61265-3961
Phone: (309) 797-5700
Fax: (309) 762-4645
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 038-003971 Illinois

Profile Details

NPI number 1568433720
LBN Legal business name Kennedy, Timothy J
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Sep 19th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568433720 NPPES
Illinois MEDICAID 038003971

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