1427116433 NPI number — California children's hospital Jamie lee Williams miss MS CRC LCPC

Table of content: Jamie lee Williams miss MS CRC LCPC (NPI 1427116433)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427116433 NPI number — California children's hospital Jamie lee Williams miss MS CRC LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
California children's hospital
Provider Last Name:
Williams
Provider First Name:
Jamie
Provider Middle Name:
lee
Provider Name Prefix Text:
Provider Name Suffix Text:
miss
Provider Credential Text:
MS CRC LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Boilinger Curtis Williams Montana Monroe Maddox Hilton westcoast Ying pickles Olsen smithswink
Provider Other First Name:
PRINCESS jab Jamie Anna Parris Anastasia shair marryKate Angelica channel Jaime
Provider Other Middle Name:
lee Nicole Ashley
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
princess jab
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427116433
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 RAVINIA PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLAND PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60462-3761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-403-7570
Provider Business Mailing Address Fax Number:
708-403-7546

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 RAVINIA PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLAND PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60462-3761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-403-7570
Provider Business Practice Location Address Fax Number:
708-403-7546
Provider Enumeration Date:
12/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  180000522 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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