Whitehead, Timothy

Whitehead, Timothy is an individual health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-5429. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Whitehead, Timothy can be contacted via phone (309) 655-2000.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-5429
Phone: (309) 655-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 35.123822 Ohio
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 82252 Wisconsin
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 35.123822 Ohio
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 036-132985 Illinois

Profile Details

NPI number 1871752428
LBN Legal business name Whitehead, Timothy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2008
Last updated Oct 13th, 2023 - about 3 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 1871752428 NPPES
Ohio MEDICAID 0104941
Ohio Other 35.123822

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