Provider Demographics
NPI:1558416008
Name:WILLIAMS, SHARON M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9730 S WESTERN AVE STE 627
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2787
Mailing Address - Country:US
Mailing Address - Phone:708-229-9816
Mailing Address - Fax:
Practice Address - Street 1:9730 S WESTERN AVE STE 627
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2787
Practice Address - Country:US
Practice Address - Phone:708-229-9816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622824OtherBCBS PROVIDER NUMBER