Healthcare Provider Details

I. General information

NPI: 1750355871
Provider Name (Legal Business Name): JOSEPH STILWILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 01/26/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12140 NALL AVE STE 200
OVERLAND PARK KS
66209-2503
US

IV. Provider business mailing address

12140 NALL AVE STE 200
OVERLAND PARK KS
66209-2503
US

V. Phone/Fax

Practice location:
  • Phone: 913-498-7409
  • Fax: 913-541-5028
Mailing address:
  • Phone: 913-498-7409
  • Fax: 913-541-5028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036113915
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036113915
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number04-35975
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: