Provider Demographics
NPI:1205809209
Name:QUAST, TIMOTHY MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:MICHAEL
Last Name:QUAST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:745 W BUCKINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2410
Mailing Address - Country:US
Mailing Address - Phone:619-806-6213
Mailing Address - Fax:312-926-6134
Practice Address - Street 1:211 E ONTARIO ST FL 7
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3468
Practice Address - Country:US
Practice Address - Phone:312-926-0008
Practice Address - Fax:312-926-6134
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.167951207RP1001X, 207RH0002X, 207RC0200X
VA0101235548207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine