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General NPI Number Information
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NPI Number | 1063531804
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Entity Type | Individual
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Provider Name | DELINDA DEMITA WILLS MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 221 NE GLEN OAK AVE
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City | PEORIA
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State | IL
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Zip | 61636-0001
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Country | US
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Telephone | 309-672-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 3225 TURTLE CREEK BLVD APT 1534
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City | DALLAS
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State | TX
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Zip | 75219-5484
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Country | US
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Telephone | 318-401-0911
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Fax | 386-226-3371
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 036163805
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | S8505
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | S8505
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License Number State | TX
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