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General NPI Number Information
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NPI Number | 1649620188
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Entity Type | Organization
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Legal Business Name | DR. JOSHUA A. WILLIAMS, LLC
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 60 REVERE DR SUITE 100
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City | NORTHBROOK
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State | IL
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Zip | 60062-1563
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Country | US
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Telephone | 224-306-1879
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Fax | 847-513-9947
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Provider Business Mailing Address
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Address Line | 60 REVERE DR SUITE 100
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City | NORTHBROOK
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State | IL
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Zip | 60062-1563
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Country | US
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Telephone | 224-306-1879
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Fax | 847-513-9947
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | JOSHUA A. WILLIAMS
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Credential | MD
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Telephone | 224-306-1879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036140532
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License Number State | IL
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