Vicky Michelle Willis, HEARING INSTURMENT S

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

HIS2254 Issued in IL

Practice address

4121 Watertower Place
Suite 3
Mount Vernon, IL 62864-2347

Phone

(618) 242-4901

Fax

(618) 242-2458

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Vicky M McCowen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1548480080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 SOUTH WATER TOWER PLACE, BELTONE HEARING",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-242-4901",
            "fax_number": "618-242-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 WATERTOWER PLACE",
            "address_2": "SUITE 3",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642347",
            "telephone_number": "618-242-4901",
            "fax_number": "618-242-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "VICKY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "HEARING INSTURMENT S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "2254",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "HIS2254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKY",
            "last_name": "MCCOWEN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lydia Ann Williams, PH.D.
• Alan D. Willis, D.D.S.
• Amber Dawn Willis, APN-BC
• Jerrold C Willis, MD
• John Ryan Willis, MD
• Angela Renee Wilson, LPC
• Elesha Wilson, LPN
• Mary J Wilson, MS LCPC
• Ronda Kaye Wilson, LPN
• Sarah Wilson, FNP-C

• Hearing Instrument Specialist in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Hearing Instrument Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.