Provider Demographics
NPI:1821009127
Name:GIAKAS, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:GIAKAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1639 N ALPINE RD
Mailing Address - Street 2:206
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1449
Mailing Address - Country:US
Mailing Address - Phone:815-395-1500
Mailing Address - Fax:815-395-1415
Practice Address - Street 1:1639 N ALPINE
Practice Address - Street 2:206
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107
Practice Address - Country:US
Practice Address - Phone:815-654-7772
Practice Address - Fax:815-654-7009
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2015-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL360839612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036083961Medicaid
ILF31173Medicare UPIN
ILK13425Medicare PIN