Provider Demographics
NPI:1932146271
Name:WILLIAMS, CLARE T (MD)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:T
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:T
Other - Last Name:FADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-0577
Mailing Address - Country:US
Mailing Address - Phone:618-985-8221
Mailing Address - Fax:618-985-6860
Practice Address - Street 1:7 S HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MURPHYSBORO
Practice Address - State:IL
Practice Address - Zip Code:62966-3333
Practice Address - Country:US
Practice Address - Phone:618-687-3418
Practice Address - Fax:618-687-1859
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111461207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCF3444OtherMEDICARE RAILROAD GROUP #
ILP00215157OtherMEDICARE RR #
IL10032052OtherBC BS NUMBER
IL370966854002Medicaid
IL640701OtherMEDICARE GROUP ID WPS FFS
IL036111461Medicaid
K46684Medicare PIN
ILCF3444OtherMEDICARE RAILROAD GROUP #
IL141840Medicare Oscar/Certification