MEDICARE: DR. GARY L WILLIAMS D.P.M.

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	213E00000X	Podiatrist	016004979	IL
2	213ES0131X	Foot Surgery Podiatrist	016004979	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396711073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY L WILLIAMS D.P.M.

Provider Business Mailing Address
First Line	:	13929 APACHE LN
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-1869
Country	:	US
Telephone Number	:	708-444-4114
Fax Number	:	708-403-9229

Provider Business Practice Location Address
First Line	:	6307 S STEWART AVE STE 202
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60621-3116
Country	:	US
Telephone Number	:	708-444-4114
Fax Number	:	708-403-9229

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	05/21/2025

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