Provider Demographics
NPI:1255479846
Name:HUGHES, WILLIAM FENNELL (ATC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FENNELL
Last Name:HUGHES
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27W734 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3128
Mailing Address - Country:US
Mailing Address - Phone:630-393-7638
Mailing Address - Fax:630-420-6596
Practice Address - Street 1:440 AURORA AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6266
Practice Address - Country:US
Practice Address - Phone:630-420-6449
Practice Address - Fax:630-420-6596
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist