Provider Demographics
NPI:1801168349
Name:FREEMAN, TIMOTHY L (RN)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:L
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25210 BLAKELY DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-6750
Mailing Address - Country:US
Mailing Address - Phone:630-749-8988
Mailing Address - Fax:
Practice Address - Street 1:25210 BLAKELY DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-6750
Practice Address - Country:US
Practice Address - Phone:630-749-8988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041359711163WH0200X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WH0200XNursing Service ProvidersRegistered NurseHome Health