TIMOTHY P OCONNOR (NPI# 1710974597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710974597 |
| Entity Type | Individual |
| Full Name | TIMOTHY P OCONNOR |
| Credential | M.D. |
| Practice Address |
420 Ne Glen Oak Ave Ste 401 Peoria IL 61603 |
| Mailing Address |
420 Ne Glen Oak Ave Ste 401 Peoria IL 61603-3168 |
| Practice Telephone | 3096768123 |
| Practice Fax Number | 3096768455 |
| Mailing Telephone | 3096768123 |
| Mailing Fax Number | 3096768455 |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2018-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204F00000X | Transplant Surgery | 036090699 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036090699 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 | 3096768123 | 3096768455 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639582869 | Timothy Oconnor | Student in an Organized Health Care Education/Training Program | 1149 South Newell, Uf Department of Neurosurgery, Gainesville, FL 32608 | 2014-06-05 |
| 1982669396 | Timothy A. Oconnor | Radiology | 1700 N Rose Ave, Suite 120, Oxnard, CA 93030-3790 | 2006-04-19 |
| 1245206440 | Timothy Albert Oconnor | Optometrist | 355 N Main St, North Brookfield, MA 01535 | 2006-02-27 |
| 1881687036 | Timothy W Oconnor | Internal Medicine | 7447 W Talcott Ave, Ste 262, Chicago, IL 60631-3745 | 2005-08-23 |
| 1962402982 | Timothy J Oconnor | Emergency Medicine | 848 Adams Ave, Memphis, TN 38103-2816 | 2005-08-01 |
| Street Address |
420 NE GLEN OAK AVE STE 401 |
| City | PEORIA |
| State | IL |
| Zip Code | 61603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962994707 | Michelle Sue Dehne | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2018-06-06 |
| 1780060517 | Danae Smith | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2015-08-04 |
| 1568848497 | Sarah Adams | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2015-08-03 |
| 1225434772 | Tonya Moore | Registered Nurse | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2014-11-11 |
| 1497172399 | Jill Oberle | Nurse Practitioner | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2014-03-28 |
| 1629344064 | David Edward Houser | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2012-03-29 |
| 1538325477 | Raji Jacob | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2008-07-30 |
| 1669648309 | Muhammad Waqar Khattak | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603 | 2008-05-02 |
| 1982816237 | Anu Vishwanath | Pediatrics | 420 Ne Glen Oak Ave Ste 401, Suite 401, Peoria, IL 61603-3168 | 2007-05-07 |
| 1124152707 | Alexander J. Alonso | Internal Medicine | 420 Ne Glen Oak Ave Ste 401, Peoria, IL 61603-3168 | 2007-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043439748 | John W Hsu | Transplant Surgery | 200 E Pennsylvania Ave, Suite 212, Peoria, IL 61603-3089 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760992739 | Pierpaolo Di Cocco | Transplant Surgery | 4041 N Keystone Ave Apt A, Chicago, IL 60641-5556 | 2017-10-04 |
| 1790203057 | Rosario Angelica Perez Gutierrez | Transplant Surgery | 5841 S Maryland Ave # 5027, Chicago, IL 60637-1443 | 2017-09-06 |
| 1083003958 | Med-care Physicians LLC | Transplant Surgery | 3s138 Park Blvd, Glen Ellyn, IL 60137-7233 | 2015-01-15 |
| 1609122159 | Jorge Alberto Almario | Transplant Surgery | 2160 S 1st Ave Rm 1739, Maywood, IL 60153-3328 | 2012-08-01 |
| 1790913093 | Inbo Shim | Transplant Surgery | 5841 S Maryland Ave # J517, Chicago, IL 60637-1447 | 2009-06-24 |
| 1659558732 | Frederick Karl Merkel | Transplant Surgery | 151 Sheridan Rd, Kenilworth, IL 60043-1214 | 2008-01-30 |
| 1568664555 | Ivo Georgiev Tzvetanov | Transplant Surgery | 840 S. Wood Street - Mc 958, Ste 402, Chicago, IL 60612-4325 | 2007-06-03 |
| 1447315270 | James M Millis | Transplant Surgery | 180 Harvester Dr Ste 300, Burr Ridge, IL 60527-7594 | 2006-12-22 |
| 1558471862 | Dympna M Kelly | Transplant Surgery | 5841 S Maryland Ave # Mc5026, Chicago, IL 60637-1443 | 2006-08-30 |
| 1124050406 | Joseph R Leventhal | Transplant Surgery | 676 N Saint Clair St Fl 19, Chicago, IL 60611-2927 | 2006-07-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.