Provider Demographics
NPI:1598204471
Name:WILLIAMS, BARBARA A (LPN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 E 53RD ST
Mailing Address - Street 2:APT 103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-3471
Mailing Address - Country:US
Mailing Address - Phone:847-800-1052
Mailing Address - Fax:
Practice Address - Street 1:69 E 53RD ST
Practice Address - Street 2:APT 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-3471
Practice Address - Country:US
Practice Address - Phone:847-800-1052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043071157164W00000X, 164X00000X
374U00000X, 376J00000X, 376K00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No347C00000XTransportation ServicesPrivate Vehicle