Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 016005509 | IL |
NPI | 1013143494 |
---|---|
Provider Name | Michael Stefan Williams |
First Address | Chicago, IL 60614-1230 |
Second Address | Chicago, IL 60614-1230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2009 |
Last Update Date | 30/10/2019 |