MEDICARE: NICOLE WILLIAMS MD

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	207VG0400X	Gynecology Physician	036116334	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01621679	OTHER	IL	BCBS OF IL
2	1235573197	OTHER	IL	CORPORATE NPI

General Provider Information

NPI Number	:	1164441051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE WILLIAMS MD

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR STE 1424
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8700
Country	:	US
Telephone Number	:	312-929-9191
Fax Number	:	312-566-8986

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR STE 1424
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-8700
Country	:	US
Telephone Number	:	312-929-9191
Fax Number	:	312-566-8986

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/06/2025

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Directions to “ NICOLE WILLIAMS MD” Practice Location

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