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Individual

MS. KATHLEEN EDNA WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1340 CHARLES ST, STE 201, ROCKFORD, IL 61104
(779) 696-8799
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8666
(779) 696-7150

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-004303
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209004303
STATE LICENSE
IL
01
264325
PERSONAL CARE
IL
Enumeration date
06/23/2005
Last updated
02/18/2021
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