BRIAN WILLIS – Acute Care Nurse Practitioner, NPI 1770363178

BRIAN WILLIS is a healthcare provider. based in Chicago, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209028421 (IL). The NPI Number for BRIAN WILLIS is 1770363178

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
BRIAN WILLIS
NPI
1770363178
Phone
(312) 996-0201
Address
1801 W TAYLOR ST
Enumeration Date
3 October 2023
Last Update Date
2 December 2024

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
8527416064
Group Practice PAC ID
3072422716
Professional Enrollment ID
I20231122001509
Address ID
IL606124795CH1801XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for BRIAN WILLIS

  • 1801 W TAYLOR ST

    CHICAGO, IL 606124795

    Phone: (312) 996-0201

    Type: Mailing

  • 800 E Woodfield Rd Ste 113

    Schaumburg, IL 601734786

    Phone: (847) 686-6866

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 52 Open Payments records for all available years, with a total value of $1,168.

Total Amount is formed as General ($1,168) + Research ($0) + Ownership ($0) = $1,168.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Lilly USA, LLC ($138).

Total Amount

$1,168

General + Research + Ownership

Payments

52

Total payment records

General Amount

$1,168

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231122001509INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60612)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3072422716View full group profile
NameSpecialtyState
Internal MedicineIL
O B S T E T R I C S/ G Y N E C O L O G YIL
-IL
-IL
Gastroenterology, Internal MedicineWI
-IL
O P H T H A L M O L O G YNY
O T O L A R Y N G O L O G YCA
Certified Registered Nurse Anesthetist (Crna)IA
G A S T R O E N T E R O L O G YFL

Reviews

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Frequently asked questions

Does BRIAN WILLIS share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BRIAN WILLIS uses 1770363178.
Is BRIAN WILLIS listed as active for patients and plans?
The listing shows BRIAN WILLIS as active in the NPI system.
What taxonomy line describes BRIAN WILLIS?
For research purposes, treat BRIAN WILLIS as Acute Care Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Does BRIAN WILLIS list a practice location?
Patients near Chicago, Illinois may find BRIAN WILLIS in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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