Ray, William John

Ray, William John is an sole proprietor health care provider with primary practice located at 2005 Jacobssen Dr Ste A, Normal IL 61761. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ray, William John can be contacted via phone (309) 807-5356.

Contact Information

Primary practice address
2005 Jacobssen Dr Ste A Normal IL 61761
Phone: (309) 807-5356
Fax: (309) 807-5291
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-081186 Illinois

Profile Details

NPI number 1689672859
LBN Legal business name Ray, William John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2005
Last updated Aug 31st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689672859 NPPES
Illinois Other 5715384 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036-081186 BLUE CROSS BLUE SHIELD

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