Individual
DEREK MICHAEL WILLGING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11971 WAGON WHEEL RD, ROCKTON, IL 61072-3322
(815) 624-2615
Mailing address
12076 TRESEMER RD, ROSCOE, IL 61073-8925
(815) 601-9513
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242005649
IL
235Z00000X
Speech-Language Pathologist
4965-154
WI
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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