MEDICARE: DR. WILLIAM NORMAN WERNER M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1073596904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM NORMAN WERNER M.D., M.P.H.

Provider Business Mailing Address
First Line	:	4326 BOBOLINK TER
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-2004
Country	:	US
Telephone Number	:	847-673-5398
Fax Number	:	773-296-7925

Provider Business Practice Location Address
First Line	:	836 W WELLINGTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5147
Country	:	US
Telephone Number	:	773-296-5888
Fax Number	:	773-296-7925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	07/08/2007

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