Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 036124731 | IL |
NPI | 1104137140 |
---|---|
Provider Name | Sherry Michele Williams |
First Address | Urbana, IL 61801-2529 |
Second Address | Herrin, IL 62948-3732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2010 |
Last Update Date | 10/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036124731 | (05) | IL |
370966854002 | (05) | IL |
640701 | MEDICARE WPS FFS (01) | IL |
CF3444 | MEDICARE RR (01) | IL |