Provider Information for 1265145643
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PARIS WILLIAMS
Sex: Female
NPI: 1265145643
Last Updated: 2025-03-28
Certification Date: 2025-03-04
Certification Date: 2025-03-04
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1265145643 | ||||||||||||
| Enumeration Date | 2023-01-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 220 E 142ND PL DOLTON, IL 60419-1114 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 220 E 142ND PL DOLTON, IL 60419-1114 United States Phone: 309-323-4117 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 1401 S 31ST ST | ||||||||||||
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