WILLIAM TILLIS NPI 1669468377

NPI Information

NPI: 1669468377
Provider Name: WILLIAM TILLIS
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

PECOS Registration: Yes

Address:
N2950 STATE ROAD 67
LAKE GENEVA, WI
ZIP 53147
Phone: (262) 245-0535
Get Directions

William Tillis is a pulmonary disease internal medicine in Lake Geneva, WI with 38 years of experience. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. William Tillis NPI is 1669468377. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:1986

The provider's business location address is:

N2950 STATE ROAD 67
LAKE GENEVA, WI
ZIP 53147-655
Phone: (262) 245-0535
Fax: (262) 245-2248

The NPI 1669468377 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/27/2005 and was last updated on 9/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RP1001X	Internal Medicine	Pulmonary Disease	83330	SOUTH CAROLINA	No
2	207RP1001X	Internal Medicine	Pulmonary Disease	81911-20	WISCONSIN	Yes
3	207RP1001X	Internal Medicine	Pulmonary Disease	036085931	ILLINOIS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036085931	MEDICAID	ILLINOIS
2	833307	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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