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NPI Code Detail

MEDICARE: TIMOTHY W LINEBERRY M.D.

MEDICARE: TIMOTHY W LINEBERRY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician45572MN
22084P0800XPsychiatry Physician62869WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912984121
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY W LINEBERRY M.D.
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 1881 CHICAGO ST
Second Line :
City : DE PERE
State : WI
Zip : 54115-3770
Country : US
Telephone Number : 920-403-8000
Fax Number : 920-403-8209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 06/02/2025

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Directions to “ TIMOTHY W LINEBERRY M.D.” Practice Location

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