Individual provider Active NPI

William Edward Dill II, EDD, ATC, CSCS

  • Athletic Trainer
  • Belleville, IL
National Provider Identifier
1144293820
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096-001756 Issued in IL
Practice address
1925 S Illinois St
Belleville, IL 62220-2879
Phone
(636) 299-0049
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 096-001756 IL Primary

Addresses

Primary practice location

1925 S Illinois St
Belleville, IL 62220-2879

Mailing address

1103 Landing Place Dr
Lake St Louis, MO 63367-4071
Phone (636) 299-0049

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

State licenses

LicenseStateTypeSpecialty
096-001756ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1144293820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 LANDING PLACE DR",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633674071",
            "telephone_number": "636-299-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 S ILLINOIS ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622202879",
            "telephone_number": "636-299-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILL",
        "first_name": "WILLIAM",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "EDD, ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096-001756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.