MEDICARE: DR. MARIA RENEA WILLIAMS APRN

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	363L00000X	Nurse Practitioner	209.033829	IL

General Provider Information

NPI Number	:	1104784834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA RENEA WILLIAMS APRN

Provider Business Mailing Address
First Line	:	5899 MASSACHUSETTS ST
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-2650
Country	:	US
Telephone Number	:	573-586-6372
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 S DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3728
Country	:	US
Telephone Number	:	618-699-0313
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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