Phyllis Diane Wille, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209-005442 Issued in IL

Practice address

611 W. Park St.
Cardiovascular and Thoracic Surgery
Urbana, IL 61801

Phone

(217) 904-7000

Fax

(217) 904-7742

NPI assigned

Nov 7, 2006

Last updated

May 16, 2014By 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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dwic of Tampa Bay, Inc.

  dba MedExpress Urgent Care - Clearwater

  • Urgent Care Clinic/Center
  • Clearwater, FL
  • NPI 1780633834
  Medicare reassignment NPD
• Medexpress Urgent Care of Boynton Beach, LLC

  dba MedExpress Urgent Care - Boynton Beach

  • Urgent Care Clinic/Center
  • Boynton Beach, FL
  • NPI 1366544728
  Medicare reassignment NPD
• Dwic of Tampa Bay, Inc.

  dba MedExpress Urgent Care - Northside

  • Urgent Care Clinic/Center
  • Tampa, FL
  • NPI 1023067220
  NPD
• Dwic of Tampa Bay, Inc.

  dba MedExpress Urgent Care

  • Urgent Care Clinic/Center
  • Clearwater, FL
  • NPI 1821047952
  NPD
• Medexpress Urgent Care of Boynton Beach, LLC

  dba MedExpress Urgent Care - Boca Raton

  • Urgent Care Clinic/Center
  • Boca Raton, FL
  • NPI 1245506807
  NPD
• Dwic of Tampa Bay, Inc

  dba MedExpress Urgent Care - Hudson, State Road 52

  • Urgent Care Clinic/Center
  • Hudson, FL
  • NPI 1598132490
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1619046174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK AVE.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "CARDIOVASCULAR AND THORACIC SURGERY",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-904-7000",
            "fax_number": "217-904-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLE",
        "first_name": "PHYLLIS",
        "middle_name": "DIANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-005442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elsa J Whitmore, D.O.
• Natalie Whittier, MS, LPC, NCC
• Alana Scopel Wiggs, RD, LDN
• Rashad Clifton Wilkerson, D.O.
• Sarah J Willard, MD
• Elizabeth Willette
• Crystal Williams
• Jacquelyn Deneen Williams
• Stephanie Williamson, LPC
• Mary Willis, SLP

• Nurse Practitioner in Urbana, IL
• Providers in Urbana, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.