Willson, Amy M

Willson, Amy M is an individual health care provider with primary practice located at 5201 Willow Springs Rd Suite 180, La Grange Highlands IL 60525-6537. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Willson, Amy M can be contacted via phone (708) 579-9705.

Contact Information

Primary practice address
5201 Willow Springs Rd Suite 180 La Grange Highlands IL 60525-6537
Phone: (708) 579-9705
Fax: (708) 579-0346
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Illinois

Profile Details

NPI number 1467552505
LBN Legal business name Willson, Amy M
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Apr 9th, 2008 - about 17 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 1467552505 NPPES
Illinois Other 31600057 BC/BS

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