Alan D. Willis
Orthodontists
1915 Broadway St
Mount Vernon
, Illinois 62864-2980
Alan D. Willis
Orthodontists
1915 Broadway St
Mount Vernon
, Illinois 62864-2980
(238) 495-7782
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About
Features
Specialties
- Orthodontists
Languages spoken
- English
Location
First Address
- Alan D. Willis
- 13340 Bridgeford Ave
- Bonita Springs, FL
- Zip : 34135-3489
- Phone : (238) 495-7782
Second Address
- Alan D. Willis
- 1915 Broadway St
- Mount Vernon, IL
- Zip : 62864-2980
- Phone : (618) 242-5600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223X0400X | Orthodontists | 19A12643 | IL |
National Provider Identifier
| NPI | 1063627982 |
|---|---|
| Provider Name | Alan D. Willis |
| First Address | Bonita Springs, FL 34135-3489 |
| Second Address | Mount Vernon, IL 62864-2980 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/05/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.