Provider Demographics
NPI:1639790181
Name:HILTON, TIMOTHY R (LHID)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:R
Last Name:HILTON
Suffix:
Gender:M
Credentials:LHID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17730 OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-3918
Mailing Address - Country:US
Mailing Address - Phone:708-532-9705
Mailing Address - Fax:708-532-9720
Practice Address - Street 1:17730 OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-3918
Practice Address - Country:US
Practice Address - Phone:708-532-9705
Practice Address - Fax:708-532-9720
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2843237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2843OtherILLINOIS DEPARTMENT OF PUBLIC HEALTH LICENSE