Willis, Carol L.

Willis, Carol L. is an individual health care provider with primary practice located at 5841 S Maryland Ave # Mc3083 , Chicago IL 60637-1447. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine. Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine is her primary health care specialty. Willis, Carol L. can be contacted via phone (773) 702-1439.

Contact Information

Primary practice address
5841 S Maryland Ave # Mc3083 Chicago IL 60637-1447
Fax:
Website:

Profile Details

NPI number 1467471813
LBN Legal business name Willis, Carol L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467471813 NPPES
Idaho MEDICAID 806950700
Idaho MEDICAID 47053951401
Idaho MEDICAID 119945500
Idaho Other P00176481

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