Timothy S Chamberlain, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-103082 Issued in IL

Practice address

701 E 3Rd St
Prophetstown, IL 61277-1334

Phone

(815) 537-5168

Fax

(815) 537-5268

NPI assigned

Nov 8, 2006

Last updated

Jun 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1598835837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 3RD ST",
            "city": "PROPHETSTOWN",
            "state": "IL",
            "postal_code": "612771334",
            "telephone_number": "815-537-5168",
            "fax_number": "815-537-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 3RD ST",
            "city": "PROPHETSTOWN",
            "state": "IL",
            "postal_code": "612771334",
            "telephone_number": "815-537-5168",
            "fax_number": "815-537-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-103082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36103082",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- RAILROAD",
            "identifier": "P00426402",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristie L Boll, DPT
• Sherwood Donald Bryan, DDS
• Kristine Byer, FNP-C
• Amy Caldwell, SLP CCC
• Kelly Jo Carter
• Core Wellness Inc (Prophetstown Family Chiropractic)
• Katrina Marie Gerber, LICENSED SOCIAL WORK
• Alexander Thomas Goodwin, PHARMD
• Hartig Drug Co Corp
• Mary Kathryn Keli Henrekin, MS, CCC-SLP

• Internal Medicine Physician in Prophetstown, IL
• Providers in Prophetstown, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.