Individual
WILLIAM SCOTT CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 JAMES ST, LAWRENCEVILLE, IL 62439-2027
(618) 943-3302
Mailing address
2101 JAMES ST, LAWRENCEVILLE, IL 62439-2027
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043123069
IL
Other
Enumeration date
09/19/2023
Last updated
09/19/2023
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