Individual
WILLIAM J VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1313 PRATT ST, BARRY, IL 62312-1365
(217) 335-2326
Mailing address
PO BOX 67, FREEMAN SPUR, IL 62841-0067
(618) 727-2263
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003181
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V250-9307-1179
DRIVERS LICENSE
IL
Enumeration date
03/26/2019
Last updated
02/09/2024
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