MEDICARE: DR. PAULETTE WILLIAMS DBA

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	172V00000X	Community Health Worker
2	376G00000X	Nursing Home Administrator

General Provider Information

NPI Number	:	1184340143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULETTE WILLIAMS DBA

Provider Business Mailing Address
First Line	:	1552 S ROUTE 59 STE 1244
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-5941
Country	:	US
Telephone Number	:	847-649-4377
Fax Number	:

Provider Business Practice Location Address
First Line	:	1552 S ROUTE 59 STE 1244
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-5941
Country	:	US
Telephone Number	:	847-649-4377
Fax Number	:

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

Provider Enumeration Date	:	10/12/2022
Last Update Date	:	08/15/2025

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