Kandice Willis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085001815 Issued in IL

Practice address

909 E Palatine Rd
Palatine, IL 60074-5551

Phone

(847) 776-1400

Fax

(847) 776-1424

NPI assigned

May 31, 2011

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 IL

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Home Physicians LLCGroup PAC ID 4981988771, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Community Home Physicians, LLC

  • Physical Medicine & Rehabilitation Physician
  • Oakbrook Terrace, IL
  • NPI 1568909505
  Medicare reassignment Care Compare group
• Noel Castelino SC

  • Rehabilitation Practitioner
  • Chicago, IL
  • NPI 1841411741
  Medicare reassignment
• American Physicians Associates LTD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1942535661
  NPD (past)
• Home Care Physicians, Inc.

  • Physician Assistant
  • Bloomingdale, IL
  • NPI 1184951469
  NPD (past)

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1811281520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E PALATINE RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600745551",
            "telephone_number": "847-776-1400",
            "fax_number": "847-776-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E PALATINE RD",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600745551",
            "telephone_number": "847-776-1400",
            "fax_number": "847-776-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "KANDICE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vered Bluma Westfall I, PTA
• White Stone Resources LTD.
• Jennifer Lee Whitman, MS, ED.S., NCSP
• Wholehearted Therapy PLLC
• Rachel Catherine Wilhelm
• Amanda Winter, LCSW
• Jared Andersen Wojnicki, D.O.
• Agnes Wojtowicz
• Rossana Di Silvio Woldman, L.C.S.W.
• Carly Wolfram, MA, LCPC

• Medical Physician Assistant in Palatine, IL
• Providers in Palatine, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.