Fendon, Timothy

Fendon, Timothy is an individual health care provider with primary practice located at 2100 Glenwood Ave , Joliet IL 60435-5487. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Fendon, Timothy can be contacted via phone (815) 999-3201.

Contact Information

Primary practice address
2100 Glenwood Ave Joliet IL 60435-5487
Phone: (815) 999-3201
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-098625 Illinois

Profile Details

NPI number 1689675811
LBN Legal business name Fendon, Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Dec 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689675811 NPPES
Indiana MEDICAID 200895510
Indiana MEDICAID 036098625
Indiana Other 000000365227

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