Provider Demographics
NPI:1326080144
Name:WILLIAMS, KENYA M (MD)
Entity Type:Individual
Prefix:DR
First Name:KENYA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KENYA
Other - Middle Name:M
Other - Last Name:STARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:SUITE 910
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-563-9060
Mailing Address - Fax:312-942-4437
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 910
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-563-9060
Practice Address - Fax:312-942-4437
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.118717207W00000X
IL036118717207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.118717OtherLICENSE