Provider Demographics
NPI:1356675516
Name:WILLIAMS, MICHAEL FERRIS JR (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FERRIS
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2241
Mailing Address - Country:US
Mailing Address - Phone:618-639-6611
Mailing Address - Fax:
Practice Address - Street 1:519 S STATE ST
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2241
Practice Address - Country:US
Practice Address - Phone:618-639-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011520111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor