Provider Demographics
NPI:1447432711
Name:BARRIS, WILLIAM SR (RSA, CSA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:BARRIS
Suffix:SR
Gender:M
Credentials:RSA, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3814 HARMONY DR
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-9549
Mailing Address - Country:US
Mailing Address - Phone:312-292-1308
Mailing Address - Fax:
Practice Address - Street 1:3814 HARMONY DR
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-9549
Practice Address - Country:US
Practice Address - Phone:312-292-1308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical