Provider Demographics
NPI:1467993444
Name:WILLIAMS, AISHAH FATIMAH (RN, CNM)
Entity Type:Individual
Prefix:MS
First Name:AISHAH
Middle Name:FATIMAH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 N CALIFORNIA AVE
Mailing Address - Street 2:APT 2F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-7074
Mailing Address - Country:US
Mailing Address - Phone:269-744-5978
Mailing Address - Fax:
Practice Address - Street 1:2024 N CALIFORNIA AVE
Practice Address - Street 2:APT 2F
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-7074
Practice Address - Country:US
Practice Address - Phone:269-744-5978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015176367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife