Provider Demographics
NPI:1477509347
Name:CREVIER, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:CREVIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16450 104TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5416
Mailing Address - Country:US
Mailing Address - Phone:708-349-0070
Mailing Address - Fax:708-349-0077
Practice Address - Street 1:16450 104TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5416
Practice Address - Country:US
Practice Address - Phone:708-349-0070
Practice Address - Fax:708-349-0077
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036074856208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036074856Medicaid
E19086Medicare UPIN