MEDICARE: CHRISTY K WILLIAMS FNP

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	209020886	IL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209.020886	IL
3	363LF0000X	Family Nurse Practitioner	209.020886	IL

General Provider Information

NPI Number	:	1235804246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY K WILLIAMS FNP

Provider Business Mailing Address
First Line	:	PO BOX 155
Second Line	:
City	:	CHRISTOPHER
State	:	IL
Zip	:	62822-0155
Country	:	US
Telephone Number	:	618-724-2401
Fax Number	:	618-724-4628

Provider Business Practice Location Address
First Line	:	107 E SMITH ST STE B
Second Line	:
City	:	BENTON
State	:	IL
Zip	:	62812-2136
Country	:	US
Telephone Number	:	618-435-9315
Fax Number	:	618-435-9316

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

Provider Enumeration Date	:	08/11/2021
Last Update Date	:	01/27/2026

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