| Doctor Name: | MR. TIMOTHY E HAZARD |
| NPI Number: | 1003199720 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 18786 |
| Business Practice Address: | 2211 S Eola Rd Aurora, IL - 605036485 |
| Business Phone Number: | 8663892727 |
| Business Fax Number: | |
| Mailing Address: | 430 Valentine Way, OSWEGO |
| State: | IL |
| Postal Code: | 605434054 |
| Phone Number: | 6305549819 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2011 |
| NPI Last Update Date: | 05/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 18786 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |