Provider Demographics
NPI:1255426169
Name:WILLIAMS, STEVEN D (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 781
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-0781
Mailing Address - Country:US
Mailing Address - Phone:815-935-7538
Mailing Address - Fax:815-935-7340
Practice Address - Street 1:300 RIVERSIDE DR.
Practice Address - Street 2:SUITE 2500
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4996
Practice Address - Country:US
Practice Address - Phone:815-939-7141
Practice Address - Fax:815-937-1670
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360757992086S0122X
IL0360751992086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036075799Medicaid
IL36075799Medicaid
IL4632039OtherBC GROUP #
IL36-3167726Medicare ID - Type UnspecifiedGROUP TAX ID#
IL356253Medicare ID - Type UnspecifiedMEDICARE GROUP #
IL4632039OtherBC GROUP #
IL36075799Medicaid