Provider Demographics
NPI:1598731572
Name:WILLIAMS, MIA F (PA)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:F
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:415 W GOLF RD STE 26
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3923
Mailing Address - Country:US
Mailing Address - Phone:855-700-8184
Mailing Address - Fax:224-633-1935
Practice Address - Street 1:1145 POQUONNOCK RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4620
Practice Address - Country:US
Practice Address - Phone:855-700-8184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2025-01-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTQ02466Medicare UPIN