Tillis, William
Tillis, William is an individual health care provider with primary practice located at N2950 State Road 67 , Lake Geneva WI 53147-2655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Tillis, William can be contacted via phone (262) 245-0535.Contact Information
Primary practice address
N2950 State Road 67
Lake Geneva WI 53147-2655
Phone: (262) 245-0535
Fax: (262) 245-2248
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 83330 | South Carolina |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 81911-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 036085931 | Illinois |
Profile Details
| NPI number | 1669468377 |
|---|---|
| LBN Legal business name | Tillis, William |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Sep 14th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669468377 | NPPES |
| Illinois | MEDICAID | 036085931 | |
| Illinois | MEDICAID | 833307 |
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