Provider Demographics
NPI:1043593239
Name:WILLIAMS, JANET M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18N525 WOODCREST LN
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-9501
Mailing Address - Country:US
Mailing Address - Phone:847-721-4180
Mailing Address - Fax:
Practice Address - Street 1:505 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1391
Practice Address - Country:US
Practice Address - Phone:630-351-3037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-037473183500000X
HIPH-1651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist