Timothy P Oconnor
Transplant Surgeon
420 Ne Glen Oak Ave Ste 401
Peoria
, Illinois 61603
Timothy P Oconnor
Transplant Surgeon
420 Ne Glen Oak Ave Ste 401
Peoria
, Illinois 61603
(309) 676-8455
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About
Features
Specialties
- Transplant Surgeon
Languages spoken
- English
Location
First Address
- Timothy P Oconnor
- 420 Ne Glen Oak Ave Ste 401
- Peoria, IL
- Zip : 61603-3168
- Fax : (309) 676-8455
- Phone : (309) 676-8123
Second Address
- Timothy P Oconnor
- 420 Ne Glen Oak Ave Ste 401
- Peoria, IL
- Zip : 61603
- Fax : (309) 676-8455
- Phone : (309) 676-8123
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204F00000X | Transplant Surgeon | 036090699 | IL |
National Provider Identifier
| NPI | 1710974597 |
|---|---|
| Provider Name | Timothy P Oconnor |
| First Address | Peoria, IL 61603-3168 |
| Second Address | Peoria, IL 61603 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/10/2005 |
| Last Update Date | 15/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036090699 | (05) | IL |
| F55642 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.