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Dr. Jerrold C Willis, MD

Diagnostic Radiology Physician in Mount Vernon, IL · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1467407072

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Registry record

Entity type Individual (Type 1)
Name Dr. Jerrold C Willis
Credential MD
Sex Male
Practice address 1 Good Samaritan Way, Radiology Dept, Mount Vernon, IL, 62864
Phone (618) 242-4600
Enumeration date May 23, 2006
Last updated in NPPES Mar 15, 2021

Taxonomy & licenses

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians · License 36057038 (IL) Primary
MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier Type State Issuer
300119485 Other IL RAILROAD ST JOES/UTLAH
300117217 Other IL RAILROAD GOOD SAM & ST MARY'S
036057038-3 Medicaid IL -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Jerrold Willis?
The National Provider Identifier (NPI) for Jerrold Willis is 1467407072, a Type 1 (individual) record in the CMS NPPES registry.
Where does Jerrold Willis practice?
The practice location on file with NPPES is in Mount Vernon, IL. Providers can have multiple locations; NPPES lists the primary practice address.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-03-15.