Individual provider Active NPI

Timothy C Hollister, MD

  • Radiation Oncology Physician
  • Wilmette, IL
National Provider Identifier
1669528428
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
036-104662 Issued in IL
Practice address
3201 Old Glenview Rd Ste 100
Wilmette, IL 60091-2964
Phone
(847) 512-1849
Fax
(847) 512-1850
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 036-104662 IL Primary

Addresses

Primary practice location

3201 Old Glenview Rd Ste 100
Wilmette, IL 60091-2964

Mailing address

3201 Old Glenview Rd Ste 100
Wilmette, IL 60091-2964
Phone (847) 512-1849

Other identifiers 1

IdentifierTypeStateIssuer
036104662MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20080707000327 IL Practitioner - Radiation Oncology 1254403322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Wisconsin School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Chicago Surgical Oncology LLCGroup PAC ID 7214107069, 13 clinicians

Practice addresses (Care Compare)

3201 Old Glenview Rd
Suite 100
Wilmette, IL 60091-2964
Phone (847) 673-6505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-104662ILMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Chicago Surgical Oncology LLC CurrentSince Jan 1, 2013 Accepting new patients
Metro Chicago Surgical Oncology LLC CurrentSince Jan 1, 2013 Accepting new patients
Midwest Radiation Oncology Consultants LTD Radiation Oncology Past Accepting new patients

Locations

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

815 Pasquinelli Dr
Westmont, IL 60559
Phone (630) 366-7854

3201 Old Glenview Rd
Ste 100
Wilmette, IL 60091
Phone (847) 512-1849

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3164/brand/1/csg/181/fhir/r4
  • Direct secure messaging: timothy.hollister.1@3164.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1669528428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 OLD GLENVIEW RD STE 100",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912964",
            "telephone_number": "847-512-1849",
            "fax_number": "847-512-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 OLD GLENVIEW RD STE 100",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912964",
            "telephone_number": "847-512-1849",
            "fax_number": "847-512-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLISTER",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IL",
            "license": "036-104662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104662",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.