Individual
MR. JOEL S WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2150 PENNSYLVANIA AVE NW, WASHINGTON, DC 20037-3201
(216) 476-7086
(202) 741-2921
Mailing address
2120 L ST NW STE 450, WASHINGTON, DC 20037-1541
(216) 476-7086
(216) 476-7604
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-050910
OH
207Q00000X
Family Medicine Physician
DO034845
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370966854002
—
IL
05
—
370966854005
—
IL
01
—
CF3444
MEDICARE RR
IL
Enumeration date
09/15/2009
Last updated
02/24/2021
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