Provider Demographics
NPI:1770574881
Name:HARTSELL, WILLIAM F (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:HARTSELL
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 1:700 COMMERCE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8736
Mailing Address - Country:US
Mailing Address - Phone:847-698-0600
Mailing Address - Fax:847-698-0600
Practice Address - Street 1:4455 WEAVER PKWY
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3269
Practice Address - Country:US
Practice Address - Phone:630-821-6400
Practice Address - Fax:888-678-4915
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360712782085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071278Medicaid
IL300084799OtherRAILROAD MEDICARE
IL920005577OtherRAILROAD MEDICARE
IL036071278Medicaid
IL920005577OtherRAILROAD MEDICARE
ILL58897Medicare ID - Type Unspecified