DR. ALEXANDER PERRY WILLETT (NPI# 1710493770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710493770 |
| Entity Type | Individual |
| Full Name | DR. ALEXANDER PERRY WILLETT |
| Credential | PSYD |
| Practice Address |
808 S Eldorado Rd Ste 102 Bloomington IL 61704-6075 |
| Practice Telephone | 3097063190 |
| Practice Fax Number | 3095884115 |
| Mailing Telephone | 3097063190 |
| Mailing Fax Number | 3095884115 |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 071009688 | IL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071009688 | IL | Behavioral Health & Social Service Providers |
| Street Address |
808 S ELDORADO RD STE 102 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-6075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053368605 | Psychology Specialists Ltd | Psychologist | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2006-05-28 |
| 1568003531 | Vanessa Iris Granger-belcher | Counselor | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2019-10-01 |
| 1588133110 | Kenleigh Roden Mcminn | Psychologist | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2018-11-13 |
| 1255853396 | Athena Dacanay | Psychologist | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2017-07-11 |
| 1467902130 | Cheryl Renee Carter | Psychologist | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2016-10-06 |
| 1588008122 | Michele M Carroll | Social Worker | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2013-04-25 |
| 1760757843 | Britain Dunaway | Counselor | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2012-03-21 |
| 1780969816 | Sarah Cain | Social Worker | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2011-10-20 |
| 1518115682 | Aaron Poppy | Psychologist | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6075 | 2008-09-03 |
| 1861538779 | Phillip Arthur Foster | Counselor | 808 S Eldorado Rd Ste 102, Bloomington, IL 61704-6071 | 2007-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326308065 | Global Athlete Village | Clinical Neuropsychologist | 3600 W 98th St, Bloomington, MN 55431-2746 | 2012-05-28 |
| 1629548136 | Nicholas John Spangler | Clinical Neuropsychologist | 1801 American Blvd E Ste 1, Bloomington, MN 55425-1230 | 2018-11-27 |
| 1023500113 | Jessica Bordenave | Clinical Neuropsychologist | 1101 E 78th St Ste 100, Bloomington, MN 55420-1402 | 2018-06-04 |
| 1699128074 | Melissa Page Fischer | Clinical Neuropsychologist | 1801 American Blvd E Ste 1, Bloomington, MN 55425-1230 | 2016-07-20 |
| 1659744043 | Aimee Custer | Clinical Neuropsychologist | 8100 Northland Dr, Bloomington, MN 55431-4800 | 2015-11-05 |
| 1922375377 | Neuropsychology Center for Attention, Behavior & Learning, LLC | Clinical Neuropsychologist | 103 N Regency Dr, Suite 1s, Bloomington, IL 61701-3503 | 2011-11-29 |
| 1265743165 | Stephen Curtis | Clinical Neuropsychologist | 205 N College Ave, Suite 713, Bloomington, IN 47404-3950 | 2010-06-24 |
| 1922168244 | Thomas Michael Misukanis | Clinical Neuropsychologist | 7800 Metro Pkwy, Suite 300, Bloomington, MN 55425-1514 | 2006-12-08 |
| 1679633093 | Minnesota Clinical & Neuropsychological Associates, P.a. | Clinical Neuropsychologist | 7800 Metro Pkwy, Suite 300, Bloomington, MN 55425-1514 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477183556 | Michelle Yvonne Kibby-faglier | Clinical Neuropsychologist | 285 Lake Indian Hills Dr, Carbondale, IL 62902-6184 | 2020-01-17 |
| 1003456708 | David Jackson | Clinical Neuropsychologist | 6 Parkway North Blvd, Deerfield, IL 60015-2522 | 2020-01-10 |
| 1649830159 | Natalie Berger | Clinical Neuropsychologist | 1645 W Jackson Blvd Ste 203, Chicago, IL 60612-3227 | 2019-06-17 |
| 1043877475 | Sarah Mailander Dyer | Clinical Neuropsychologist | 900 Royal Heights Rd Ste 14, Belleville, IL 62226-5457 | 2019-05-21 |
| 1639655632 | Julia Digangi | Clinical Neuropsychologist | 920 N York Rd, Hinsdale, IL 60521-2996 | 2018-07-13 |
| 1891211710 | Kenneth Vicencio | Clinical Neuropsychologist | 4100 Healthway Drive, Aurora, IL 60504 | 2017-08-22 |
| 1538690466 | Kathleen Ares | Clinical Neuropsychologist | 4440 W 95th, Suite 1200h, Oak Lawn, IL 60453 | 2017-03-22 |
| 1225575871 | Israel Gross | Clinical Neuropsychologist | 1934 W. Roscoe St., #4, Chicago, IL 60657 | 2017-01-20 |
| 1013462829 | Ann Westcot Jordan | Clinical Neuropsychologist | 21037 Benjamin Dr, Shorewood, IL 60404-0612 | 2016-08-22 |
| 1740638915 | Elizabeth Regina Tuminello Hartman | Clinical Neuropsychologist | 1875 Dempster St Ste 520, Park Ridge, IL 60068-1130 | 2016-05-29 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.