Individual
JOHN JEFFREY WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2101
(309) 664-3422
Mailing address
602 W UNIVERSITY AVE, URBANA, IL 61801-2530
(217) 383-3311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85001294
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
Enumeration date
09/20/2006
Last updated
11/19/2007
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