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NPI Code Detail

MEDICARE: CANDICE WILLIAMS

MEDICARE: CANDICE WILLIAMS
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
1101YP2500XProfessional Counselor178.019361IL

General Provider Information

NPI Number : 1174390074
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE WILLIAMS
Provider Business Mailing Address
First Line : 4070 N KENMORE AVE APT 8
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2471
Country : US
Telephone Number : 773-420-6109
Fax Number :
Provider Business Practice Location Address
First Line : 53 W JACKSON BLVD STE 1615
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3722
Country : US
Telephone Number : 815-317-6498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2023
Last Update Date : 12/18/2023

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Directions to “ CANDICE WILLIAMS ” Practice Location

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