Mikesell, Timothy John
Mikesell, Timothy John is an individual health care provider with primary practice located at 1775 Ballard Rd , Park Ridge IL 60068-1005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Mikesell, Timothy John can be contacted via phone (847) 318-2400.Contact Information
Primary practice address
1775 Ballard Rd
Park Ridge IL 60068-1005
Phone: (847) 318-2400
Fax: (847) 318-2558
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036102613 | Illinois |
Profile Details
| NPI number | 1811933757 |
|---|---|
| LBN Legal business name | Mikesell, Timothy John |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Dec 17th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811933757 | NPPES |
| Illinois | MEDICAID | 036102613 |
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