Healthcare Provider Details

I. General information

NPI: 1376597732
Provider Name (Legal Business Name): GAIL D WILLIAMSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

762 E CHESTNUT ST
CANTON IL
61520-2845
US

IV. Provider business mailing address

12323 TOWERLINE RD
PEKIN IL
61554-8715
US

V. Phone/Fax

Practice location:
  • Phone: 309-353-6301
  • Fax: 844-813-1772
Mailing address:
  • Phone: 309-620-3381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036078962
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036078962
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: