TIMOTHY L CONNELLY (NPI# 1801821509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801821509 |
| Entity Type | Individual |
| Full Name | TIMOTHY L CONNELLY |
| Credential | MD |
| Practice Address |
602 W University Ave Urbana IL 61801-2530 |
| Mailing Address |
Po Box 6002 Urbana IL 61801-2530 |
| Practice Telephone | 2173833311 |
| Mailing Telephone | 2173268300 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
036060683 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD | 770000124 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720570385 | Timothy Jacob Connelly | Behavior Technician | 1725 Presidio Way, Plumas Lake, CA 95961-9071 | 2018-05-30 |
| 1467616748 | Timothy Patrick Connelly Jr. | Internal Medicine | 1101 Lexington Ave, Savannah, GA 31404 | 2008-07-15 |
| 1992963722 | Timothy Richard Connelly | Physical Therapist | 650 Joel Drive, Blanchfield Army Community Hospital, Fort Campbell, KY 42223-5349 | 2008-05-29 |
| 1407986631 | Timothy Gerard Connelly | Anesthesiology | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2007-03-06 |
| 1750492559 | Timothy John Connelly | Anesthesiology | 5125 Skyline Rd S, Salem, OR 97306-9427 | 2006-08-31 |
| Street Address |
602 W UNIVERSITY AVE |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932194016 | Michael Shane Hennesy | Obstetrics & Gynecology | 602 W University Ave, Urbana, IL 61801-2530 | 2005-09-15 |
| 1265043996 | Brett E Smith | Pharmacist | 602 W University Ave, Urbana, IL 61801-2530 | 2020-08-14 |
| 1457753337 | Caroline Hudoba | Pharmacist | 602 W University Ave, Urbana, IL 61801-2530 | 2014-09-22 |
| 1124456363 | Nolan Jenkins | Dentist | 602 W University Ave, Urbana, IL 61801-2530 | 2013-10-25 |
| 1093147043 | Stephanie Freeman | Nurse Anesthetist, Certified Registered | 602 W University Ave, Urbana, IL 61801-2530 | 2013-08-01 |
| 1376988949 | Vanadhi Kannan | Nurse Anesthetist, Certified Registered | 602 W University Ave, Urbana, IL 61801-2530 | 2013-05-08 |
| 1336482025 | Carle Health Care Incorporated | Family Medicine | 602 W University Ave, Urbana, IL 61801-2530 | 2013-04-01 |
| 1427397884 | Hannah M Balow | Nurse Practitioner | 602 W University Ave, Urbana, IL 61801-2530 | 2013-02-05 |
| 1427309020 | Kathleen Voelker | Nurse Practitioner | 602 W University Ave, Urbana, IL 61801-2530 | 2012-09-24 |
| 1144575598 | Nathan V Mcclelland | Nurse Anesthetist, Certified Registered | 602 W University Ave, Urbana, IL 61801-2530 | 2012-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699858068 | Ravishankar Hasanadka | Surgery | 1405 W Park St Ste 201, Urbana, IL 61801-2368 | 2006-10-21 |
| 1154317683 | Aamir M Zakaria | Surgery | 602 West University Avenue, Urbana, IL 61801 | 2005-09-20 |
| 1033384722 | Brian Robert Beeman | Surgery | 611 W Park St, Hvi, Urbana, IL 61801-2529 | 2008-04-24 |
| 1881701308 | Pamela M Moore | Surgery | 611 W. Park St., Cardiology, Urbana, IL 61801-2500 | 2006-08-23 |
| 1457382913 | Michael Colla | Surgery | 602 W University Ave, Urbana, IL 61801-2530 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267324 | Congress Vascular Center LLC | Surgery | 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 | 2017-07-11 |
| 1043731300 | Elmwood Park Vascular Center LLC | Surgery | 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 | 2017-06-27 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1992126668 | Vascular Specialists LLC | Surgery | 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 | 2013-12-26 |
| 1588959548 | Patrick Michael Sullivan Neville | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2011-06-17 |
| 1235454968 | Margaret Claire Rigamer | Surgery | 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 | 2010-04-06 |
| 1215251541 | John V. White, Md, LLC | Surgery | 8816 W Dempster St, Niles, IL 60714-5109 | 2010-03-15 |
| 1710212733 | Vascular Surgery and Interpretation S.c. | Surgery | 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 | 2009-10-08 |
| 1538391792 | Usa Vein Clinics of Chicago LLC | Surgery | 4141 Dundee Rd, Northbrook, IL 60062-2129 | 2009-08-20 |
| 1306010731 | Tanq, Inc. | Surgery | 18510 S Marilynn Ct, Mokena, IL 60448-9517 | 2008-04-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.