Dr. Timothy A Kisla, DO
Ophthalmology in New Lenox, IL. Individual provider (NPI-1).
NPI number1477557445
StatusActive
Last updated in NPPESJul 31, 2023
Details
- NPI
- 1477557445
- Entity type
- Individual (NPI-1)
- Name
- Dr. Timothy A Kisla
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 8, 2005
- Certification date
- Jul 31, 2023
- Last updated
- Jul 31, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | 036097974 | IL | Yes |
Practice location
1870 Silver Cross BlvdSuite 110
New Lenox, IL 60451-8639
Phone 815-485-2727 · Fax 815-485-3034
Mailing address
1870 Silver Cross BlvdSuite 110
New Lenox, IL 60451-8639
Phone 815-485-2727 · Fax 815-485-3034
Other practice locations
15900 W 127th St Ste 200
Lemont, IL 60439-2912
Lemont, IL 60439-2912
Phone 815-485-2727 · Fax 815-485-3034
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