Healthcare Provider Details

I. General information

NPI: 1861888257
Provider Name (Legal Business Name): ALICIA ELIZABETH WILLIAMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

5323 HARRY HINES BLVD
DALLAS TX
75390-9087
US

V. Phone/Fax

Practice location:
  • Phone: 312-227-4800
  • Fax:
Mailing address:
  • Phone: 214-456-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD0000057287
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.149203
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT9530
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberT9530
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: