Provider Demographics
NPI:1700892601
Name:MYERS, WILLIAM G (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2042 N CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4517
Mailing Address - Country:US
Mailing Address - Phone:707-348-2020
Mailing Address - Fax:
Practice Address - Street 1:9150 CRAWFORD AVE STE 201
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1770
Practice Address - Country:US
Practice Address - Phone:847-677-2794
Practice Address - Fax:847-677-2833
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36059607207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0281300001OtherDMERC
IL697351Medicare ID - Type Unspecified
IL0281300001OtherDMERC