Individual provider Active NPI

Willa L Williamson, APN

  • Adult Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1083623573
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209-002276 Issued in IL
Practice address
1901 S. Harrison St.
Chicago, IL 60612-3714
Phone
(312) 864-5218
Fax
(312) 864-9638
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Registered Nurse 163WU0100X 209-002276 IL
Adult Health Nurse Practitioner 363LA2200X 209-002276 IL Primary

Addresses

Primary practice location

1901 S. Harrison St.
Chicago, IL 60612-3714

Mailing address

9218 S Longwood Dr
Chicago, IL 60620-5543
Phone (312) 864-5218

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wwilliamso@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-002276ILMDUrology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Apr 24, 2012 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Apr 24, 2012 Accepting new patients

Locations

25706 Network Pl
Chicago, IL 60673

4909 W Division St
Chicago, IL 60651
Phone (773) 854-8000

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1900 W Polk St
Ste 1200
Chicago, IL 60612

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1083623573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9218 S LONGWOOD DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205543",
            "telephone_number": "312-864-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S. HARRISON ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-5218",
            "fax_number": "312-864-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "WILLA",
        "middle_name": "L",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WU0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Urology",
            "state": "IL",
            "license": "209-002276",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-002276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wwilliamso@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.