Theresa Willis, RPH,MBA

Primary specialty

PharmacistTaxonomy code 183500000X

License

051034923 Issued in IL

Practice address

2615 Edwards St Ste 102
Alton, IL 62002-3915

Phone

(618) 208-6937

Fax

(618) 208-0291

NPI assigned

Aug 23, 2016

Last updated

Aug 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Genoa Healthcare LLC

  • Long Term Care Pharmacy
  • Alton, IL
  • NPI 1497126262
  NPD (past)

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1437604089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 EDWARDS ST STE 102",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023915",
            "telephone_number": "618-208-6937",
            "fax_number": "618-208-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 EDWARDS ST STE 102",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023915",
            "telephone_number": "618-208-6937",
            "fax_number": "618-208-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "RPH,MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051034923",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2011015233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine M Williams, CHWC, CD(DONA)
• Leslie Williams
• Marie Williams, BA
• Patricia Williams
• Stephanie Williams, DPT
• Alysya Wilson, BS
• Jennifer A Wilson, MS, QMHP
• Stephanie R Wilson
• Florence Ann Wilton, M.A., CCC-SP
• Win You Care for Health LLC

• Pharmacist in Alton, IL
• Providers in Alton, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.