Individual
DR. ALEX BRIAN WILLIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2020 W ILES AVE, SPRINGFIELD, IL 62704-4174
(217) 698-3030
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
(217) 698-3030
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
03616914
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2018
Last updated
10/16/2022
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