Provider Demographics
NPI:1346591260
Name:TONER, TIMOTHY LELAND
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:LELAND
Last Name:TONER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 N DIXON ST
Mailing Address - Street 2:
Mailing Address - City:RANKIN
Mailing Address - State:IL
Mailing Address - Zip Code:60960-7057
Mailing Address - Country:US
Mailing Address - Phone:217-397-2629
Mailing Address - Fax:
Practice Address - Street 1:304 N DIXON ST
Practice Address - Street 2:
Practice Address - City:RANKIN
Practice Address - State:IL
Practice Address - Zip Code:60960-7057
Practice Address - Country:US
Practice Address - Phone:217-397-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT177842246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist