Provider Demographics
NPI:1285684688
Name:WOODWARD, WILLIAM D (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1300 COPPERFIELD AVE
Mailing Address - Street 2:SUITE 3030
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-2004
Mailing Address - Country:US
Mailing Address - Phone:815-740-1900
Mailing Address - Fax:815-729-3294
Practice Address - Street 1:1300 COPPERFIELD AVE
Practice Address - Street 2:SUITE 3030
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-2004
Practice Address - Country:US
Practice Address - Phone:815-740-1900
Practice Address - Fax:815-729-3294
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036050962207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036050962Medicaid
IL036050962Medicaid
ILL55771Medicare PIN
ILP09436Medicare PIN
ILC43290Medicare UPIN
ILL55720Medicare PIN