Healthcare Provider Details

I. General information

NPI: 1851325088
Provider Name (Legal Business Name): TIMOTHY KUZEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 WEST AVE STE 108
ORLAND PARK IL
60462-4685
US

IV. Provider business mailing address

15300 WEST AVE STE 108
ORLAND PARK IL
60462-4685
US

V. Phone/Fax

Practice location:
  • Phone: 708-226-2318
  • Fax: 708-226-2319
Mailing address:
  • Phone: 708-226-2318
  • Fax: 708-226-2319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number036071755
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: