Individual
MICHELLE L WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2701 W 68TH ST, CHICAGO, IL 60629-1813
(773) 884-4010
Mailing address
939 W BELLE PLAINE AVE, #3, CHICAGO, IL 60613-2168
(630) 418-3148
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.001333
IL
363A00000X
Physician Assistant
PA22806
CA
Other
Enumeration date
08/17/2006
Last updated
10/24/2017
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