Charles C. Willis

Physical Therapy Assistant · Chicago, IL

Individual Active NPI

NPI number 1174066492

Practice location

2649 E 75TH St
Chicago, IL 60649-3835
Phone
(773) 356-9300

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NPI record

NPI
1174066492
Entity type
Individual (Type 1)
Enumeration date
November 18, 2016
Last updated
November 18, 2016
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 160007583 IL

About Charles Willis

Charles C. Willis is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 2649 E 75TH St, Chicago, IL 60649-3835. The NPI number 1174066492 was assigned on November 18, 2016 and the record was last updated on November 18, 2016.

Charles Willis lists a license in the registry: #160007583 (IL) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Charles C. Willis?

The NPI number is 1174066492.

What is the phone number of Charles Willis?

The phone number listed for the practice location is (773) 356-9300.

Where is Charles Willis located?

2649 E 75TH St, Chicago, IL 60649-3835.

What is the taxonomy code for Charles Willis?

The primary taxonomy code is 225200000X – Physical Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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