Individual provider Active NPI

Sean Thomas Williams, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1255712626
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036144052 Issued in IL
Practice address
5645 W Addison St
Dept of Emergency Medicine
Chicago, IL 60634-4403
Phone
(773) 794-8383
Fax
(773) 794-4686
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036144052 IL Primary

Addresses

Primary practice location

5645 W Addison St
Dept of Emergency Medicine
Chicago, IL 60634-4403

Mailing address

5645 W Addison St
Dept of Emergency Medicine
Chicago, IL 60634-4403

Other practice location 1

7435 W Talcott Ave
Chicago, IL 60631-3707
Phone (773) 774-8000

Other practice location 2

7435 W Talcott Ave
Chicago, IL 60631-3707
Phone (773) 774-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swilliams59918@ce-direct.presencehealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180503000502 IL Practitioner - Emergency Medicine 2769786003 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036144052ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community First Healthcare of Illinois, Inc. CurrentSince Oct 20, 2018 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Oct 20, 2018 Accepting new patients
Community First Healthcare of Illinois, Inc. Emergency Medicine Current Accepting new patients
Presence Healthcare Services Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

5645 W Addison St
Ste 301
Chicago, IL 60634
Phone (773) 736-4553

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1255712626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "address_2": "DEPT OF EMERGENCY MEDICINE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "address_2": "DEPT OF EMERGENCY MEDICINE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "773-794-8383",
            "fax_number": "773-794-4686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7435 W Talcott Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606313707",
            "country_code": "US",
            "telephone_number": "773-774-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7435 W Talcott Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606313707",
            "country_code": "US",
            "telephone_number": "773-774-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SEAN",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036144052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swilliams59918@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "7435 W Talcott Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606313707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.