Healthcare Provider Details

I. General information

NPI: 1598204471
Provider Name (Legal Business Name): BARBARA A WILLIAMS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 E 53RD ST APT 103
CHICAGO IL
60615-3471
US

IV. Provider business mailing address

69 E 53RD ST APT 103
CHICAGO IL
60615-3471
US

V. Phone/Fax

Practice location:
  • Phone: 847-800-1052
  • Fax:
Mailing address:
  • Phone: 847-800-1052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number043071157
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number043071157
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: