Petsche, Timothy S

Petsche, Timothy S is an individual health care provider with primary practice located at 2525 Kaneville Rd , Geneva IL 60134-2578. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Petsche, Timothy S can be contacted via phone (630) 584-1400.

Contact Information

Primary practice address
2525 Kaneville Rd Geneva IL 60134-2578
Fax: (630) 584-1733
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 036101880 Illinois
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036-101880 Illinois

Profile Details

NPI number 1124099809
LBN Legal business name Petsche, Timothy S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Dec 30th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124099809 NPPES
Other 200038329 RAILROAD MEDICARE
Other CF2064 RAILROAD MEDICARE
MEDICAID 036101880 RAILROAD MEDICARE
Other 753210 RAILROAD MEDICARE

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