Organization
EPIC GROUP-EMERGENCY PHYSICIANS AN ILLINOIS CONCERN S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ELLIS WILLIAMSON DO (AUTHORIZED OFFICIAL)
(708) 691-1253
Entity
Organization
Contact information
Practice address
150 W HIGH ST, MORRIS, IL 60450-1463
(815) 942-0553
Mailing address
PO BOX 4777, OAK BROOK, IL 60522-4777
(866) 898-7147
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03223219
BLUE CROSS BLUE SHIELD
IL
01
—
CG0558
RAILROAD MEDICARE
IL
Enumeration date
07/09/2006
Last updated
05/02/2024
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