Provider Demographics
NPI:1568446516
Name:WILLIAMS, FARION (MD)
Entity Type:Individual
Prefix:DR
First Name:FARION
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 PARKVIEW AVE
Mailing Address - Street 2:CREDENTIALING S200
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1822
Mailing Address - Country:US
Mailing Address - Phone:815-395-5851
Mailing Address - Fax:815-395-5644
Practice Address - Street 1:1221 E STATE ST
Practice Address - Street 2:UNIVERSITY FAMILY HEALTH CENTER
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-2231
Practice Address - Country:US
Practice Address - Phone:815-972-1000
Practice Address - Fax:815-972-1033
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF88746Medicare UPIN
IL917150Medicare ID - Type UnspecifiedPROVIDER ID# FHC