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General NPI Number Information
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NPI Number | 1851236178
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Entity Type | Individual
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Provider Name | KENNETH WILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 211 N HAMMES AVE STE 1A
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City | JOLIET
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State | IL
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Zip | 60435-8113
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Country | US
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Telephone | 815-290-0902
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Fax | 509-753-2503
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Provider Business Mailing Address
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Address Line | 553 BLUEBIRD DR
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4878
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Country | US
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Telephone | 630-209-2331
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | IL
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