Timothy Michael Corzine, LCSW
Individual provider Active NPI Case Manager/Care Coordinator · Vienna, IL
NPI 1609219385 · NPPES record last updated Apr 11, 2013
Key facts
- NPI
- 1609219385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 149011475 (IL)
- Practice address
- 4890 Buncombe Rd
Vienna, IL 62995-2446 - Phone
- (618) 579-6233
- NPI assigned
- Apr 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149011475 | IL | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 149011475 | IL | Yes |
Addresses
Primary practice location
4890 Buncombe Rd
Vienna, IL 62995-2446
Mailing address
4890 Buncombe Rd
Vienna, IL 62995-2446
Phone (618) 579-6233
Other providers in Vienna, IL
- Brittany Bulfer
- Brandi Campbell
- John Cantrell
- Lexi Clark
- Fallon Clayton I
- County of Johnson
- Sherrie Leann Crabb
- Sharon Craig
- Martha Jane Crawford
- Mary Elizabeth Daubert
All providers in Vienna, IL · Case Manager/Care Coordinator in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.