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General NPI Number Information
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NPI Number | 1205625449
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Entity Type | Individual
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Provider Name | KORI WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 523 E 154TH ST
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City | PHOENIX
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State | IL
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Zip | 60426-2310
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Country | US
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Telephone | 872-348-4708
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Fax |
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Provider Business Mailing Address
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Address Line | 6545 W DICKENS AVE APT 2W
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City | CHICAGO
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State | IL
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Zip | 60707-3482
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Country | US
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Telephone | 708-400-0679
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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