Provider Demographics
NPI:1952475170
Name:WILLIAM D. MCCARTHY, M.D., LLC.
Entity Type:Organization
Organization Name:WILLIAM D. MCCARTHY, M.D., LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-429-3314
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:IL
Mailing Address - Zip Code:60966-0369
Mailing Address - Country:US
Mailing Address - Phone:815-429-3314
Mailing Address - Fax:815-429-3490
Practice Address - Street 1:160 EAST GROVE ST
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IL
Practice Address - Zip Code:60966
Practice Address - Country:US
Practice Address - Phone:815-429-3314
Practice Address - Fax:815-429-3490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03832012OtherBCBS OF IL
IL03832012OtherBCBS OF IL
IL212597Medicare ID - Type Unspecified