Jackie Augustus Williams, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036.060095 Issued in IL

Practice address

7556 Jackson Blvd
Forest Park, IL 60130-1854

Phone

(708) 838-8610

NPI assigned

May 23, 2013

Last updated

May 23, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1285071738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 S LUELLA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492513",
            "telephone_number": "773-493-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7556 JACKSON BLVD",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301854",
            "telephone_number": "708-838-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JACKIE",
        "middle_name": "AUGUSTUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-23",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.060095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine J Weisensee, PTA
• West Suburban Medical Center (Womens Health Center)
• Yvonetta White
• Whitec, Inc
• Calisa Williams
• Khairee Williams
• Skyy Derajane Williams, RBT
• Julianna Elizabeth Holzer Winter
• Vanessa Wittich
• Joshua Woodruff, DMD

• Obstetrics & Gynecology Physician in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.