=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376490037
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARA WILLIAMS
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2026
-----------------------------------------------------
Last Update Date | 03/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2806 N KNOXVILLE AVE
-----------------------------------------------------
City | PEORIA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61604-2870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 309-655-6961
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1520 S MISSOURI AVE
-----------------------------------------------------
City | MORTON
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61550-9023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-320-8511
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 070029766
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------