Individual
WILLSON HARTZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
676 N SAINT CLAIR ST, STE 1525, CHICAGO, IL 60611-2927
(312) 951-5640
(312) 266-0478
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(773) 767-8283
(773) 767-8320
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621690
BLUE SHIELD
IL
Enumeration date
05/25/2006
Last updated
07/13/2026
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