Individual
MISS SHIRLEY VERNETHA WILLIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
13136 WESTERN AVE, BLUE ISLAND, IL 60406-2423
(708) 974-5800
(708) 371-0466
Mailing address
13136 WESTERN AVE, BLUE ISLAND, IL 60406-2423
(708) 974-5800
(708) 371-0466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041-161525
IL
Other
Enumeration date
06/14/2011
Last updated
06/23/2011
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