Poland, Timothy Joseph

Poland, Timothy Joseph is an individual health care provider with primary practice located at 1162 W Maple Ave , Mundelein IL 60060-1438. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Poland, Timothy Joseph can be contacted via phone (847) 367-2400.

Contact Information

Primary practice address
1162 W Maple Ave Mundelein IL 60060-1438
Phone: (847) 367-2400
Fax: (847) 367-2440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036081143 Illinois

Profile Details

NPI number 1124069455
LBN Legal business name Poland, Timothy Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Oct 13th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124069455 NPPES
Illinois MEDICAID 036081143

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