Healthcare Provider Details

I. General information

NPI: 1164934113
Provider Name (Legal Business Name): KARLEE WILLIAMS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 S MILWAUKEE AVE STE 307
LIBERTYVILLE IL
60048-3773
US

IV. Provider business mailing address

1435 DEERFIELD PL
HIGHLAND PARK IL
60035-3056
US

V. Phone/Fax

Practice location:
  • Phone: 847-557-0645
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.102588
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: