Individual
IRA LEE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9801 S KARLOV AVE APT 203, OAK LAWN, IL 60453-3443
(773) 593-5805
Mailing address
9801 S KARLOV AVE APT 203, OAK LAWN, IL 60453-3443
(773) 593-5805
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
W45241279266
—
Other
Enumeration date
02/14/2020
Last updated
02/14/2020
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