Provider Demographics
NPI:1760632459
Name:WILLIAM C. DAM, M.D.S.C.
Entity Type:Organization
Organization Name:WILLIAM C. DAM, M.D.S.C.
Other - Org Name:ALL TIME MEDICAL & URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-587-3004
Mailing Address - Street 1:214 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60041-9208
Mailing Address - Country:US
Mailing Address - Phone:847-587-3004
Mailing Address - Fax:847-587-4325
Practice Address - Street 1:214 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:IL
Practice Address - Zip Code:60041-9208
Practice Address - Country:US
Practice Address - Phone:847-587-3004
Practice Address - Fax:847-587-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3647653207N00000X, 207R00000X
261QM1300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4900842OtherBLUECROSS BLUESHIELD
IL036047653Medicaid
IL036047653Medicaid