Individual
DR. TINA MARIE SCHADE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202
(317) 948-7128
Mailing address
PO BOX 719094, CHICAGO, IL 60677-9318
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
01080559A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
01080559A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
0400964
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300015476
—
IN
Enumeration date
08/13/2006
Last updated
02/13/2026
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