Individual
ANGELA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5777
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209013715
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209013715
IL LICENSE
IL
Enumeration date
01/07/2016
Last updated
01/07/2016
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