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Individual

DR. BRUCE EDWARD WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
8120 GEORGIA ST, SUITE B, MERRILLVILLE, IN 46410-6390
(847) 390-7666
(847) 390-9345
Mailing address
1455 E GOLF RD, SUITE 110, DES PLAINES, IL 60016-1250
(847) 390-7666
(847) 390-9345

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000747
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
016004547
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016004547
IL
05
100167720A
IN
Enumeration date
06/14/2006
Last updated
12/14/2016
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