Provider Demographics
NPI:1659387173
Name:WILLIAMS, SARAH ELICIA (APN-BC, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELICIA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APN-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2857
Mailing Address - Country:US
Mailing Address - Phone:312-791-3455
Mailing Address - Fax:312-791-4158
Practice Address - Street 1:2525 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2315
Practice Address - Country:US
Practice Address - Phone:312-791-3455
Practice Address - Fax:312-791-4158
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005327363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILQ36145Medicare UPIN