Healthcare Provider Details

I. General information

NPI: 1023231289
Provider Name (Legal Business Name): WILLOWBROOK MEDICAL CENTER LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 PLAINFIELD ROAD SUITE C
WILLOWBROOK IL
60527
US

IV. Provider business mailing address

535 PLAINFIELD ROAD SUITE C
WILLOWBROOK IL
60527
US

V. Phone/Fax

Practice location:
  • Phone: 630-986-7501
  • Fax: 630-986-7505
Mailing address:
  • Phone: 630-986-7501
  • Fax: 630-986-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number036078620
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number036078620
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036078620
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036078620
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number036078620
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number036078620
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number036078620
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number036078620
License Number StateIL
# 9
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036073808
License Number StateIL

VIII. Authorized Official

Name: MR. ANTHONY L. BILOTTA
Title or Position: PRESIDENT
Credential: D.O.
Phone: 630-986-7501