Provider Demographics
NPI:1811652639
Name:MCWILLIAMS, JAQUELINE (APN)
Entity type:Individual
Prefix:
First Name:JAQUELINE
Middle Name:
Last Name:MCWILLIAMS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 E WOODFIELD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4776
Mailing Address - Country:US
Mailing Address - Phone:847-605-9500
Mailing Address - Fax:
Practice Address - Street 1:804 E WOODFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4776
Practice Address - Country:US
Practice Address - Phone:847-605-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.022859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily