Basic Information
| Provider Information | |||||||||
| NPI: | 1033669791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLS | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | RITA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1335 N MILL ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605632047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306468000 | ||||||||
| FaxNumber: | 6306468007 | ||||||||
| Practice Location | |||||||||
| Address1: | 1335 N MILL ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605632047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306468000 | ||||||||
| FaxNumber: | 6306468007 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2016 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 150.101475 | IL | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | IL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.