Active NPI
Deandre Ramon Williams, MD
- Emergency Medicine Physician
- Maywood, IL
National Provider Identifier
1457312373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036117328
- Practice address
- 2160 S First Ave
Maywood, IL 60153 - Phone
- (708) 216-9000
- NPI assigned
- Mar 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036117328 | IL | Primary |
Addresses
Primary practice location
2160 S First Ave
Maywood, IL 60153
Mailing address
2160 S First Ave
Maywood, IL 60153
Phone (708) 216-9000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1531384 | Other | PA | HIGHMARK BS |
| 1008194480001 | Medicaid | PA | |
| 2216927000 | Other | PA | INDEPENDENCE BC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chestnut Hill Emergency Associates LTD | Emergency Medicine | Past | Accepting new patients |
| Emergency Physician Associates of Pennsylvania, PC | Emergency Medicine | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Philadelphia, PA
- NPI 1588628176
-
- Emergency Medicine Physician
- Hanover, PA
- NPI 1619990900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554422400000",
"number": "1457312373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2160 S FIRST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "60153",
"telephone_number": "708-216-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2160 S FIRST AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "60153",
"telephone_number": "708-216-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DEANDRE",
"middle_name": "RAMON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-30",
"last_updated": "2019-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036117328",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BS",
"identifier": "1531384",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1008194480001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BC",
"identifier": "2216927000",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.