Provider Demographics
NPI:1134328644
Name:WILLIAMS, JEFFREY J (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9223 W SAINT FRANCIS RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8330
Mailing Address - Country:US
Mailing Address - Phone:815-806-3111
Mailing Address - Fax:815-464-2621
Practice Address - Street 1:305 VINE ST
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1666
Practice Address - Country:US
Practice Address - Phone:815-463-4746
Practice Address - Fax:815-463-4937
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036117200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036117200OtherLICENSE