Amy M Willson, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5201 Willow Springs Rd
Suite 180
La Grange Highlands, IL 60525-6537

Phone

(708) 579-9705

Fax

(708) 579-0346

NPI assigned

Sep 25, 2006

Last updated

Apr 9, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Midwest Surgical Associates, S.C.

  • Specialist
  • La Grange Highlands, IL
  • NPI 1881729879
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1467552505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD",
            "address_2": "SUITE 180",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256537",
            "telephone_number": "708-579-9705",
            "fax_number": "708-579-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 WILLOW SPRINGS RD",
            "address_2": "SUITE 180",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605256537",
            "telephone_number": "708-579-9705",
            "fax_number": "708-579-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "31600057",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel J Traverso, DO
• Sara Elizabeth Uhlir, NURSE PRACTITIONER
• Uropartners, LLC
• Walgreen Co (Walgreens #04874)
• Ryan Michael Weiss, MD
• Barbara F Willson, PA
• Amanda S Wilson, ATC
• Workright Occupational Health Services SC
• Eric Yang, MD
• Fahed Zeitoun, SURGICAL ASSISTANT

• Physician Assistant in La Grange Highlands, IL
• Providers in La Grange Highlands, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.