Provider Demographics
NPI:1548246820
Name:ADAMS, BILLIE (MD)
Entity type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 EAST 75TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-3646
Mailing Address - Country:US
Mailing Address - Phone:773-288-4824
Mailing Address - Fax:773-288-3995
Practice Address - Street 1:2011 EAST 75TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3646
Practice Address - Country:US
Practice Address - Phone:773-288-4824
Practice Address - Fax:773-288-3995
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036037561208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036037561Medicaid
IL01621679OtherBCBS OF IL
IL01621679OtherBCBS OF IL