Individual
MS. VIVIAN E. WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-8000
Mailing address
185 PENNY AVE, EAST DUNDEE, IL 60118-1454
(847) 836-7015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041182580
IL
367500000X
Certified Registered Nurse Anesthetist
28170894A
IN
Other
Enumeration date
06/06/2006
Last updated
02/14/2019
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