Oconnor, Timothy P
Oconnor, Timothy P is an individual health care provider with primary practice located at 420 Ne Glen Oak Ave Ste 401 , Peoria IL 61603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Transplant Surgery, which is considered as his primary health care specialty. Oconnor, Timothy P can be contacted via phone (309) 676-8123.Contact Information
Primary practice address
420 Ne Glen Oak Ave Ste 401
Peoria IL 61603
Phone: (309) 676-8123
Fax: (309) 676-8455
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Transplant Surgery | 204F00000X | 036090699 | Illinois |
Profile Details
| NPI number | 1710974597 |
|---|---|
| LBN Legal business name | Oconnor, Timothy P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2005 |
| Last updated | Nov 15th, 2021 - about 4 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 | 1710974597 | NPPES |
| Illinois | MEDICAID | 036090699 |
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