Provider Demographics
NPI:1669534186
Name:CUMMINGS, TIMOTHY CHARLES (PSYD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:CHARLES
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S. YORK ROAD
Mailing Address - Street 2:SUITE #215
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-3432
Mailing Address - Country:US
Mailing Address - Phone:773-201-1527
Mailing Address - Fax:
Practice Address - Street 1:116 S. YORK ST.
Practice Address - Street 2:SUITE #215
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3432
Practice Address - Country:US
Practice Address - Phone:773-201-1527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist