Paul Jay Willis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

4709 Golf Rd
#1005
Skokie, IL 60076-1231

Phone

(847) 677-2404

Fax

(847) 677-7432

NPI assigned

Oct 12, 2006

Sex

Male

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

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699864322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD",
            "address_2": "#1005",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761231",
            "telephone_number": "847-677-2404",
            "fax_number": "847-677-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD",
            "address_2": "#1005",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761231",
            "telephone_number": "847-677-2404",
            "fax_number": "847-677-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PAUL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI",
            "identifier": "1689765679",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Anne Wilke
• William J. Kafin, MD.SC
• Cheryl Ann Williams, MS, RDN, LDN, CDCES
• Katherine M Williams, MD
• Willis Abt Dental Practice
• Jenny Mat-an Willy, RN
• Christine Wilson, APRN
• Jerome Laurence Wilson, PA-C
• Winfield Woods Healthcare Center LLC
• Michele Lynn Winiarz, PA-C

• General Practice Dentistry in Skokie, IL
• Providers in Skokie, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.