Basic Information
Provider Information
NPI: 1003803552
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOWNE
FirstName: WILLIAM
MiddleName: P
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 351 DELNOR DR
Address2: SUITE 100
City: GENEVA
State: IL
PostalCode: 601344220
CountryCode: US
TelephoneNumber: 6302320280
FaxNumber: 3602323895
Practice Location
Address1: 351 DELNOR DR
Address2: SUITE 100
City: GENEVA
State: IL
PostalCode: 601344220
CountryCode: US
TelephoneNumber: 6302320280
FaxNumber: 3602323895
Other Information
ProviderEnumerationDate: 09/30/2005
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X036090103ILY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X036090103ILN Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

ID Information
IDTypeStateIssuerDescription
P0093271701ILRR MEDICARE PTAN (INDIVIDUAL)OTHER
20614701ILMEDICARE PTAN (GROUP)OTHER
03609010305IL MEDICAID
20614705701ILMEDICARE PTAN (INDIVIDUAL)OTHER


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