Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | IL |
NPI | 1225189913 |
---|---|
Provider Name | Dr. Timothy G Chiu |
First Address | Park Ridge, IL 60068-1802 |
Second Address | Park Ridge, IL 60068-1802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |