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NPI Code Detail

MEDICARE: JANNEICE WILLIAMS RN

MEDICARE:   JANNEICE  WILLIAMS  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse041.251747IL

General Provider Information

NPI Number : 1255573804
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNEICE WILLIAMS RN
Provider Business Mailing Address
First Line : 149 N PARKSIDE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60644-3040
Country : US
Telephone Number : 773-287-9744
Fax Number :
Provider Business Practice Location Address
First Line : 149 N PARKSIDE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60644-3040
Country : US
Telephone Number : 773-287-9744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2009
Last Update Date : 03/28/2009

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