Individual provider Active NPI

Julie Williams, PA-C

  • Medical Physician Assistant
  • Antioch, IL
National Provider Identifier
1114441011
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085006255 Issued in IL
Practice address
420 E Il Route 173 Ste 101
Antioch, IL 60002-7284
Phone
(847) 652-9700
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085006255 IL Primary

Addresses

Primary practice location

420 E Il Route 173 Ste 101
Antioch, IL 60002-7284

Mailing address

420 E Il Route 173 Ste 101
Antioch, IL 60002-7284
Phone (847) 652-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031002099 IL Practitioner - Physician Assistant 2668748963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake County Immediate Care, LLCGroup PAC ID 6204158280, 15 clinicians

Practice addresses (Care Compare)

1849 Green Bay Rd
Suite 171
Highland Park, IL 60035-3152
Phone (847) 901-8400

420 E Il Route 173
Suite 101
Antioch, IL 60002-7284
Phone (847) 652-9700

724 N Green Bay Rd
Waukegan, IL 60085-2236
Phone (847) 901-8400

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Immediate Care, LLC CurrentSince Apr 20, 2019 Accepting new patients

Locations

420 E Il Route 173
Ste 101
Antioch, IL 60002
Phone (847) 652-9700

1849 Green Bay Rd
Ste 171
Highland Park, IL 60035
Phone (847) 901-8400

724 N Green Bay Rd
Waukegan, IL 60085
Phone (847) 901-8400

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1114441011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E IL ROUTE 173 STE 101",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600027284",
            "telephone_number": "847-652-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E IL ROUTE 173 STE 101",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600027284",
            "telephone_number": "847-652-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JULIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085006255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

Verify at the official NPI Registry.