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Individual
MR. DON P WILLARD
Active
Individual
MR. DON P WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070012412
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146700
MEDICARE PART A
IL
01
—
3721757
BLUE CROSS BLUE SHIELD OF IL
IL
Enumeration date
03/23/2007
Last updated
04/20/2011
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