License holder summary

Tim S Provias is a Board Of Registration In Medicine licensed to practice in Massachusetts. The address on file for Tim S Provias is Northwestern Medicine, 675 N St Clair St, Galter 19-100, Chicago 60611. This licensed professional license is current. The license was granted 04/10/2013 and expired on 01/08/2018.

Massachusetts

Division of Professional Licensure

Tim S Provias
Board Of Registration In Medicine
License number
254220
Date granted
04/10/2013
Date expires
01/08/2018
Class
Board Of Registration In Medicine
Status
Active
Address
Northwestern Medicine, 675 N St Clair St, Galter 19-100
licensingma.org
ID 41468505
LAST UPDATED 2026-05-05 04:12:50 UTC

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