MEDICARE: DR. WALTER R. WILLIAMS M.D.

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	207Q00000X	Family Medicine Physician	036-048928	IL

General Provider Information

NPI Number	:	1447926860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALTER R. WILLIAMS M.D.

Provider Business Mailing Address
First Line	:	40 SMOKE TREE RD
Second Line	:
City	:	HILLSBORO
State	:	IL
Zip	:	62049-2104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 SMOKE TREE RD
Second Line	:
City	:	HILLSBORO
State	:	IL
Zip	:	62049-2104
Country	:	US
Telephone Number	:	217-532-3534
Fax Number	:

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

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	03/07/2023

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