Moran, Timothy

Moran, Timothy is an individual health care provider with primary practice located at 500 W Court St , Kankakee IL 60901-3661. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Moran, Timothy can be contacted via phone (815) 937-2100.

Contact Information

Primary practice address
500 W Court St Kankakee IL 60901-3661
Phone: (815) 937-2100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-076975 Illinois

Profile Details

NPI number 1457535759
LBN Legal business name Moran, Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2007
Last updated Mar 27th, 2009 - about 17 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 1457535759 NPPES
Illinois MEDICAID 036076975
Illinois Other 4622394

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