Provider Demographics
NPI:1033757349
Name:TIMKO, ARIANNA (PSYD)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:TIMKO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 S PROMONTORY DRIVE
Mailing Address - Street 2:C/O BEHAVIORAL HEALTH DEPARTMENT
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649
Mailing Address - Country:US
Mailing Address - Phone:773-256-5723
Mailing Address - Fax:773-363-7664
Practice Address - Street 1:6501 S PROMONTORY DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-1002
Practice Address - Country:US
Practice Address - Phone:773-256-5723
Practice Address - Fax:773-363-7664
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
IL071.010221103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional