Williams, James Bertram

Williams, James Bertram is an individual health care provider with primary practice located at 2420 W Nebraska Ave , Peoria IL 61604-3112. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Williams, James Bertram can be contacted via phone (309) 680-5000.

Contact Information

Primary practice address
2420 W Nebraska Ave Peoria IL 61604-3112
Phone: (309) 680-5000
Fax: (309) 680-1002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 036099138 Illinois
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036099138 Illinois

Profile Details

NPI number 1265433882
LBN Legal business name Williams, James Bertram
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2005
Last updated Jun 28th, 2011 - about 13 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 1265433882 NPPES
Illinois Other P00059260 RETIRED RAILROAD MEDICARE
Illinois MEDICAID 036099138 RETIRED RAILROAD MEDICARE
Illinois Other IL0101/010794248-01 RETIRED RAILROAD MEDICARE
Illinois Other 7232062 RETIRED RAILROAD MEDICARE

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