Provider Demographics
NPI:1669579462
Name:HESS, WILLIAM P SR (DPM)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:HESS
Suffix:SR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1144
Mailing Address - Country:US
Mailing Address - Phone:618-997-9369
Mailing Address - Fax:618-997-4755
Practice Address - Street 1:1506 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1144
Practice Address - Country:US
Practice Address - Phone:618-997-9369
Practice Address - Fax:618-997-4755
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37706Medicare UPIN
IL672720Medicare ID - Type Unspecified