Provider Demographics
NPI:1013983139
Name:MEYER, TIMOTHY A (ATC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:A
Last Name:MEYER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 EASTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-7311
Mailing Address - Country:US
Mailing Address - Phone:847-229-8425
Mailing Address - Fax:
Practice Address - Street 1:900 S ELMHURST RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5507
Practice Address - Country:US
Practice Address - Phone:847-718-7136
Practice Address - Fax:847-718-7138
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer