Healthcare Provider Details

I. General information

NPI: 1093544983
Provider Name (Legal Business Name): WILLOW RHEUMATOLOGY AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 PLAINFIELD RD STE D
WILLOWBROOK IL
60527-7608
US

IV. Provider business mailing address

535 PLAINFIELD RD STE D
WILLOWBROOK IL
60527-7608
US

V. Phone/Fax

Practice location:
  • Phone: 434-962-8466
  • Fax:
Mailing address:
  • Phone: 630-277-9018
  • Fax: 866-531-8584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELA CROWLEY
Title or Position: OWNER
Credential: MD
Phone: 630-277-9018