Healthcare Provider Details

I. General information

NPI: 1235379769
Provider Name (Legal Business Name): RONALD O WILLIAMS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 HILLTOP DR
MORRISON IL
61270-9536
US

IV. Provider business mailing address

1008 HILLTOP DR
MORRISON IL
61270-9536
US

V. Phone/Fax

Practice location:
  • Phone: 815-772-7122
  • Fax: 815-734-3194
Mailing address:
  • Phone: 815-772-7122
  • Fax: 815-734-3194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number038003346
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038003346
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: