Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 220589 | MA |
N | 208600000X | Surgeon | 220589 | MA |
N | 208200000X | Surgeon | N7763 | TX |
N | 208600000X | Surgeon | N7763 | TX |
Y | 2086S0102X | Surgical Critical Care | 036149381 | IL |
NPI | 1205904190 |
---|---|
Provider Name | Dr. Brian Henry Williams |
First Address | Burr Ridge, IL 60527-5965 |
Second Address | Chicago, IL 60637-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 05/08/2019 |