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General NPI Number Information
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NPI Number | 1275944571
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Entity Type | Individual
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Provider Name | MR. DOSHAINE WILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 1725 W HARRISON STREET SUITE 1156
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 312-942-5458
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Fax |
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Provider Business Mailing Address
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Address Line | 2241 W SHAKESPEARE AVE 2
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City | CHICAGO
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State | IL
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Zip | 60647
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Country | US
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Telephone | 786-459-1261
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209013878
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License Number State | IL
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