Search › Illinois › 174M00000X
Bradley Willis
NPI 1922419605 · on the registry since 2014 · sole proprietor
Practice
- Address
- 105 N Main St
Athens, IL 62613 - Phone
- (217) 636-7388
Registry record
- Primary taxonomy
- 174M00000X
174M00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-05-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois