Healthcare Provider Details

I. General information

NPI: 1598750200
Provider Name (Legal Business Name): TIMOTHY VALE VOTAPKA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TIM VOTAPKA M.D.

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27750 W HIGHWAY 22 SUITE 100
BARRINGTON IL
60010-2379
US

IV. Provider business mailing address

9500 BORMET DR STE 204
MOKENA IL
60448-8399
US

V. Phone/Fax

Practice location:
  • Phone: 847-816-3000
  • Fax: 877-676-1549
Mailing address:
  • Phone: 708-346-4044
  • Fax: 708-346-3287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036076786
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number55112-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number036076786
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: