| Dr James Bertram Williams, MD | |
|
2420 W Nebraska Ave, Peoria, IL 61604-3112 | |
| (309) 680-5000 | |
| (309) 680-1002 |
| Full Name | Dr James Bertram Williams |
|---|---|
| Gender | Male |
| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
| Location | 2420 W Nebraska Ave, Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265433882 | NPI | - | NPPES |
| P00059260 | Other | IL | RETIRED RAILROAD MEDICARE |
| 036099138 | Medicaid | IL | |
| IL0101/010794248-01 | Other | IL | JOHN DEERE |
| 7232062 | Other | IL | BLUE SHIELD PROVIDER NO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 036099138 (Illinois) | Primary |
| 2086S0129X | Surgery - Vascular Surgery | 036099138 (Illinois) | Secondary |
| Entity Name | Cardiac Thoracic & Endovascular Therapies Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962417485 PECOS PAC ID: 0749258580 Enrollment ID: O20040920001183 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr James Bertram Williams, MD 2420 W Nebraska Ave, Peoria, IL 61604-3112 Ph: (309) 680-5000 | Dr James Bertram Williams, MD 2420 W Nebraska Ave, Peoria, IL 61604-3112 Ph: (309) 680-5000 |
Paul A Siebert, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 1001 Main St, Suite 300, Peoria, IL 61606 Phone: 309-495-0200 Fax: 309-353-4380 | |
Dr. Mark D Plunkett, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 420 Ne Glen Oak Ave Ste 301, Suite 301, Peoria, IL 61603 Phone: 309-655-3453 Fax: 309-624-3852 |