Active NPI
Kimberly Sue Williams, D.C.
- Internist Chiropractor
- Rockford, IL
National Provider Identifier
1700937307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- License
- 038.010875
- Practice address
- 6019 Fincham Dr
Rockford, IL 61108-2550 - Phone
- (815) 708-1025
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 038.010875 | IL | Primary |
Addresses
Primary practice location
6019 Fincham Dr
Rockford, IL 61108-2550
Mailing address
6019 Fincham Dr
Rockford, IL 61108-2550
Phone (815) 708-0125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10132239 | Other | IL | BLUE CROSS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.010875 | IL | MD | Internist Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477267200000",
"number": "1700937307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6019 FINCHAM DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082550",
"telephone_number": "815-708-0125",
"fax_number": "815-316-1069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6019 FINCHAM DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082550",
"telephone_number": "815-708-1025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KIMBERLY",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2016-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "IL",
"license": "038.010875",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "10132239",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.