Provider Information for 1114104437
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Mr. SEBASTION ANTHONY WILLIAMS M.S.Ed., L.C.P.C.
Sex: Male
NPI: 1114104437
Last Updated: 2008-01-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1114104437 | ||||||||
| Enumeration Date | 2008-01-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 13136 WESTERN AVE BLUE ISLAND, IL 60406-2423 United States Phone: 708-974-5855 | Fax:312-829-0710 | ||||||||
| Primary Practice Address | 13136 WESTERN AVE BLUE ISLAND, IL 60406-2423 United States Phone: 708-974-5855 | Fax:312-829-0710 | ||||||||
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