Provider Demographics
NPI:1093123556
Name:WILLIAMS, CYNTHIA (FNP-BC, LAC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP-BC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17W705 BUTTERFIELD RD STE D
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4363
Mailing Address - Country:US
Mailing Address - Phone:630-777-5912
Mailing Address - Fax:630-344-1313
Practice Address - Street 1:17W705 BUTTERFIELD RD STE D
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4363
Practice Address - Country:US
Practice Address - Phone:630-777-5912
Practice Address - Fax:630-344-1313
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.358856163W00000X
IL198.001136171100000X
IL277.000814363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No171100000XOther Service ProvidersAcupuncturist
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner