Individual
DR. ANTHONY P WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1921 4TH ST, PERU, IL 61354-3309
(815) 223-0151
(815) 223-0307
Mailing address
1921 4TH ST, PERU, IL 61354-3309
(815) 223-0151
(815) 223-0307
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046006923
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028447001
DMERC REGION B
IL
05
—
046006923
—
IL
01
—
05021930
BCBS PROVIDER NUMBER
IL
01
—
L39590
PIN NUMBER
IL
Enumeration date
12/22/2005
Last updated
05/17/2010
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