Willett, Paul D

Willett, Paul D is an individual health care provider with primary practice located at 1015 S Mercer Ave , Bloomington IL 61701-7107. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Willett, Paul D can be contacted via phone (309) 706-3190.

Contact Information

Primary practice address
1015 S Mercer Ave Bloomington IL 61701-7107
Phone: (309) 706-3190
Fax: (309) 452-9028
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071.007268 Illinois

Profile Details

NPI number 1710199948
LBN Legal business name Willett, Paul D
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2007
Last updated Aug 7th, 2009 - about 15 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710199948 NPPES
Illinois Other 05732025 BLUE CROSS BLUE SHIELD
Illinois Other 117151 BLUE CROSS BLUE SHIELD
Illinois Other K39590 BLUE CROSS BLUE SHIELD

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