Provider Demographics
NPI:1023398567
Name:WILLIAMS, LEORA JILL (PHARMACIST)
Entity Type:Individual
Prefix:MS
First Name:LEORA
Middle Name:JILL
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W. GOLF
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2410
Mailing Address - Country:US
Mailing Address - Phone:847-296-5145
Mailing Address - Fax:847-296-5178
Practice Address - Street 1:17 W. GOLF
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2410
Practice Address - Country:US
Practice Address - Phone:847-296-5145
Practice Address - Fax:847-296-5178
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-031847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist