Active NPI
Willard O. Elyea, M.D.
- Family Medicine Physician
- Joliet, IL
National Provider Identifier
1023218070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 2848 McDonough St
Joliet, IL 60436-1050 - Phone
- (815) 725-1206
- Fax
- (815) 741-1579
- NPI assigned
- Jul 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary |
Addresses
Primary practice location
2848 McDonough St
Joliet, IL 60436-1050
Mailing address
9000 N Lindbergh Dr
Peoria, IL 61615-1417
Phone (309) 272-1582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036041077 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Professionals, LTD. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- Peoria, IL
- NPI 1841384898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184716800000",
"number": "1023218070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 N LINDBERGH DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616151417",
"telephone_number": "309-272-1582",
"fax_number": "309-272-1583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2848 MCDONOUGH ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604361050",
"telephone_number": "815-725-1206",
"fax_number": "815-741-1579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELYEA",
"first_name": "WILLARD",
"middle_name": "O.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2007-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.