DR. BRADLEY WILLIS (NPI# 1922419605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922419605 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY WILLIS |
| Practice Address |
105 N Main St Athens IL 62613-8901 |
| Mailing Address |
Po Box 65 Athens IL 62613-0065 |
| Practice Telephone | 2176367388 |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-05-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174M00000X | Veterinarian | 090008708 | IL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689782781 | Bradley W Willis | Dentist | 8161 Seaton Place, Suite A, Montgomery, AL 36116 | 2006-08-28 |
| 1558893412 | Bradley Willis | Pharmacist | 130 W Ravine Rd, Kingsport, TN 37660-3837 | 2017-03-30 |
| 1891175345 | Bradley Jerome Willis | Family Medicine | 1201 3rd Ave Se, Cedar Rapids, IA 52403-4009 | 2015-05-30 |
| 1578777389 | Bradley S Willis | Family Medicine | 400 Fairview Heights Rd, Summersville, WV 26651-9308 | 2007-05-10 |
| Street Address |
105 N MAIN ST |
| City | ATHENS |
| State | IL |
| Zip Code | 62613-8901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467543629 | Athens Comm Unit School District 213 | Local Education Agency (LEA) | #1 Warrior Way, Athens, IL 62613 | 2006-09-27 |
| 1689133068 | Mary Embalabala | Specialist/Technologist | 17586 Kincaid St, Athens, IL 62613-7574 | 2019-03-15 |
| 1477099646 | Julianne A Manuel | Pharmacy | 202 N West St, Athens, IL 62613-7665 | 2017-01-12 |
| 1437690567 | Gleason Pharmacy Services Inc | Pharmacy | 214 Abe Lincoln Dr Unit 2, Athens, IL 62613-7800 | 2017-03-08 |
| 1700096484 | Amanda Evelyn Biggins | Registered Nurse | 712 S Harvest Rd, Athens, IL 62613-9514 | 2007-05-23 |
| 1356471031 | Joyce Sydney Taylor | Speech-Language Pathologist | 11553 Leinberger Rd, Athens, IL 62613-9621 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508797 | Vince R Koping | Pharmacist | 929 East State St, Athens, OH 45701 | 2020-11-06 |
| 1164023529 | Aderholt Medical, LLC | Family Medicine | 320 Old Us-31 N, Athens, AL 35611 | 2020-11-03 |
| 1386244242 | Athens Home Care Solutions LLC | Home Health Aide | 215 W Burr Oak, Athens, MI 49011-9731 | 2020-10-29 |
| 1619576485 | Angels Mobile Phlebotomy Services LLC | Technician, Pathology | 185 Kirby Ln, Athens, GA 30606-1683 | 2020-10-22 |
| 1336748219 | Athens Eye Consultants LLC | Ophthalmology | 650 Oglethorpe Ave Ste 5, Athens, GA 30606-2216 | 2020-10-21 |
| 1023617305 | Evaline J Trevias | Occupational Therapist | 125 Appleby Dr, Athens, GA 30605-1748 | 2020-10-19 |
| 1861091282 | Wild & Free Occupational Therapy, LLC | Occupational Therapist | 20582 Harris Rd, Athens, AL 35614-4500 | 2020-10-19 |
| 1063010437 | Miranda Browne | Massage Therapist | 335 Roberts Rd, Athens, GA 30606-1227 | 2020-10-16 |
| 1295333409 | Olivia Palmer | Nurse Practitioner | 770 W Market St, Athens, AL 35611 | 2020-10-12 |
| 1063010189 | Soms Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 1061 Dowdy Rd Ste 201, Athens, GA 30606-5700 | 2020-10-12 |
| Find all providers in ATHENS | ||||
| Taxonomy Code | 174M00000X |
| Grouping | Other Service Providers |
| Classification | Veterinarian |
| A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |
| Notes: Source: Dorland’s Illustrated Medical Dictionary. 28th edition. Philadelphia: W.B. Saunders Company, 1994, p. 1823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144602434 | Peter Haase | Veterinarian | 1195 E Palatine Rd, Arlington Heights, IL 60004-3313 | 2015-06-23 |
| 1720467335 | Sarah Pruss | Veterinarian | 2079 Lincoln Hwy, St Charles, IL 60174-1580 | 2015-05-28 |
| 1992190441 | Robert Robbins | Veterinarian | 4287 Eldamain Rd, Plano, IL 60545-9711 | 2015-04-01 |
| 1619369824 | Russell Jones | Veterinarian | 720 Kennedy Dr, Metropolis, IL 62960-2630 | 2015-02-25 |
| 1538566278 | Jennifer Armstrong | Veterinarian | 9351 Old Highway 13, Murphysboro, IL 62966-5530 | 2014-11-24 |
| 1700283587 | Catherine O'keefe | Veterinarian | 22096 N Pet Ln, Prairie View, IL 60069-4112 | 2014-11-22 |
| 1770992026 | Andrea Kuehn | Veterinarian | 225 W Division St, Chicago, IL 60610-1820 | 2014-08-11 |
| 1316362908 | Cherlene Delgado | Veterinarian | 820 W Frontage Rd, Northfield, IL 60093-1205 | 2014-02-19 |
| 1265855803 | Shawna Nicole Greene | Veterinarian | 2600 W. Galena Blvd., Aurora, IL 60506 | 2014-02-03 |
| 1922421882 | Christopher Shule | Veterinarian | 11711 Catalpa Ln, Woodstock, IL 60098-6924 | 2014-01-29 |
| Find all providers with the same taxonomy | ||||
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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.