Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | IL |
NPI | 1356448344 |
---|---|
Provider Name | Dr. William Joseph Powell |
First Address | Hinsdale, IL 60521-4433 |
Second Address | Hinsdale, IL 60521-4433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |