Individual
KHADIJAH ANDREA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 W CHERRY ST APT 4, NORMAL, IL 61761-4595
(815) 901-3770
Mailing address
104 W CHERRY ST APT 4, NORMAL, IL 61761-4595
(815) 901-3770
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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