Individual provider Active NPI

Gail D Williamson, MD

  • Internal Medicine Physician
  • Canton, IL
National Provider Identifier
1376597732
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036078962 Issued in IL
Practice address
762 E Chestnut St
Canton, IL 61520-2845
Phone
(309) 353-6301
Fax
(844) 813-1772
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036078962 IL
Internal Medicine Physician 207R00000X 036078962 IL Primary

Addresses

Primary practice location

762 E Chestnut St
Canton, IL 61520-2845

Mailing address

12323 Towerline Rd
Pekin, IL 61554-8715
Phone (309) 620-3381

Other identifiers 3

IdentifierTypeStateIssuer
036078962MedicaidIL
09015685OtherILBLUE CROSS BLUE SHIELD
110173926OtherILRAIL ROAD MEDICARE PIN

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
I20090811000440 IL Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Pediatric Medicine 3173677143 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Point Hospice LLC CurrentSince Feb 1, 2021 Accepting new patients
Comfort Plus Hospice Inc. CurrentSince May 10, 2022 Accepting new patients

Locations

762 E Chestnut St
Canton, IL 61520
Phone (309) 353-6301

7150 N University St
Peoria, IL 61614
Phone (309) 620-9821

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Serenity Point Hospice LLCCanton, IL, CCN 141708 Hospice 5% Or Greater Direct Ownership Interest (25%)
W-2 Managing Employee (25%)
Dec 15, 2020
Feb 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1376597732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12323 TOWERLINE RD",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615548715",
            "telephone_number": "309-620-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 E CHESTNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202845",
            "telephone_number": "309-353-6301",
            "fax_number": "844-813-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "GAIL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036078962",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036078962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078962",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09015685",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE PIN",
            "identifier": "110173926",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

Verify at the official NPI Registry.