Provider Demographics
NPI:1598750200
Name:VOTAPKA, TIMOTHY VALE (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:VALE
Last Name:VOTAPKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TIM
Other - Middle Name:
Other - Last Name:VOTAPKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9500 BORMET DR STE 204
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8399
Mailing Address - Country:US
Mailing Address - Phone:708-346-4044
Mailing Address - Fax:708-346-3287
Practice Address - Street 1:27750 W HIGHWAY 22
Practice Address - Street 2:SUITE 100
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2379
Practice Address - Country:US
Practice Address - Phone:847-816-3000
Practice Address - Fax:877-676-1549
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036076786208600000X, 208G00000X
WI55112-20208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036076786Medicaid
IL01618941OtherBCBS
IN200538010BMedicaid
WI1598750200Medicaid
IL211578007Medicare PIN
WI1598750200Medicaid
ILK07428Medicare PIN
IL060055516Medicare PIN
IL01618941OtherBCBS
ILE96685Medicare UPIN
IN200538010BMedicaid
ILK10039Medicare PIN