William G Nulty

MD | Pediatric Adolescent Medicine | Male

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Complete Profile:

William G Nulty basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Adolescent Medicine
Provider Name :	William G Nulty
Credential :	MD
Gender :	Male

Business Address:

William G Nulty address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	One Illini Dr, Medical Service Plan Peoria, IL, 61605 United States
Phone Number :	309-671-8503

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1639148356
NPI Entity Type :	Individual
First Enrolment Date :	15 Mar, 2006
Last Updated On :	09 Jul, 2007

Medicare Participation:

William G Nulty participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	8628252939
Medicare Enrollment ID :	I20110412000263
Primary Specialty :	Internal Medicine
Medical School :	Other
Graduation Year :	1990
Accepts Medicare?	Yes. William G Nulty accepts medicare insurance.

Group Practice Association:

William G Nulty is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which William G Nulty is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Osf Multi-specialty Group	3678889789	1468	5111 N Glen Park Place Rd Peoria, IL - 616144675 Ph: 3096835700	Yes
Osf Multi-specialty Group	3678889789	1468	8600 State Route 91 Suite 130 Peoria, IL - 616157829 Ph: 3096835050	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for William G Nulty are as mentioned. Primary taxonomy code for William G Nulty, MD is 2080A0000X (Pediatrics Adolescent Medicine).

Taxonomy Code	Speciality	Primary	License No.	State
2080A0000X	Pediatrics Adolescent Medicine	Yes	036085410	IL

Legacy Identifiers:

Other legacy medical identifiers of William G Nulty such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
IL01DC	Other	IL	JOHN DEERE
07215036	Other	IL	BCBS
036085410	MEDICAID	IL

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	1 Illini Dr Peoria, IL, 61605-2576 United States
Phone Number :	309-671-8503

Business Location:

Patients can refer following map for directions to William G Nulty practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.