MISS SHIRLEY VERNETHA WILLIS III REGISTERED NURSE
NPI 1285929620
Registered Nurse in Blue Island, IL

NPI Status: Active since June 14, 2011

Contact Information

13136 WESTERN AVE
BLUE ISLAND, IL
ZIP 60406
Phone: (708) 974-5800
Fax: (708) 371-0466

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  • Individual
  • Female
  • Years of Experience 12
  • Registered Nurse
  • Accepts Insurance
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About SHIRLEY WILLIS

This page provides the complete NPI Profile along with additional information for Shirley Willis, a provider established in Blue Island, Illinois with a medical specialization in Registered Nurse and more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1285929620 assigned on June 2011. The practitioner's primary taxonomy code is 163W00000X with license number 041-161525 (IL). The provider is registered as an individual and her NPI record was last updated 14 years ago.

NPI
1285929620
Provider Name
MISS SHIRLEY VERNETHA WILLIS III REGISTERED NURSE
Gender
Female
Entity Type
Individual
Location Address
13136 WESTERN AVE BLUE ISLAND, IL 60406
Location Phone
(708) 974-5800
Location Fax
(708) 371-0466
Mailing Address
13136 WESTERN AVE BLUE ISLAND, IL 60406
Mailing Phone
(708) 974-5800
Mailing Fax
(708) 371-0466
Medical School Name
OTHER
Graduation Year
2014
Is Sole Proprietor?
No
Enumeration Date
06-14-2011
Last Update Date
06-23-2011
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A registered nurse (RN) like Shirley Willis coordinates and provides patient care and educates patients about various health conditions. Registered nurses give advice and emotional support to patients and their families. The typical duties of a registered nurse include: assessing patient conditions, record medical histories and symptoms, observe patients and record the observations, administer medicines and treatments, consult and collaborate with doctors, operate and monitor medical equipment, teach patients and families how to manage injuries or illnesses, etc.

Registered nurses typically work as part of a team with physicians and other healthcare professionals. In some medical teams registered nurses supervise nursing assistants, licensed practical nurses, and home health aides.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Registered Nurse

Taxonomy Code
163W00000X
Type
Nursing Service Providers
License No.
041-161525
License State
IL
Taxonomy Description
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Choice Preferred Bronze PPO? 201 - PPO
  • Blue Choice Preferred Bronze PPO? 701 - PPO
  • Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
  • Blue Choice Preferred Gold PPO? 204 - PPO
  • Blue Choice Preferred Gold PPO? 901 - PPO
  • Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
  • Blue Choice Preferred Security PPO? 200 - PPO
  • Blue Choice Preferred Silver PPO? 203 - PPO
  • Blue Choice Preferred Silver PPO? 801 - PPO
  • Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Shirley Willis is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Shirley Willis is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7012434616

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20250507001771

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: Yes

Reviews for MISS SHIRLEY VERNETHA WILLIS III REGISTERED NURSE

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1285929620
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221651821864
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 6 + 5 + 1 + 8 + 2 + 1 + 8 + 6 + 4 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1285929620 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1295859577MRS. MICHELLE ELIZABETH CHURCHEY-MIMS MA
Individual
Counselor (Professional)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5856
1114104437MR. SEBASTION ANTHONY WILLIAMS M.S.ED., L.C.P.C.
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5855
1922325299 LORETTA CARPENTER MA, LCPC
Individual
Counselor (Professional)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(773) 371-2949
1952694663MRS. MELISSA DAWN QUIJANO
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5827
1154615755MR. LOUIS VOLPI III C.R.S.S.
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5800
1366736936MS. MARINA CAJAS MHP
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5800
1730424292 MARIA PACHECO
Individual
Counselor (Mental Health)13136 WESTERN AVE METROPOLITAN FAMILY SERVICES SOUTHWEST
BLUE ISLAND, IL 60406
(708) 974-5800
1205269057MR. JOHN PETER MUCKIAN JR. LPC
Individual
Counselor (Professional)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5800
1487075768 KRISTEN HOFMAN LCSW
Individual
Social Worker (Clinical)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5800
1740607852 JORDAN HEATH
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(866) 333-6723
1861804353 JACQUELINE SCARBOROUGH AIKERSON
Individual
Social Worker (Clinical)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5842
1285033274 JAIME CHAVEZ LPC
Individual
Counselor (Professional)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5822
1750780474 UKELA SHELTON
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5848
1134528854 MELISSA COLEMAN
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5849
1790184448MS. ARLEASE COLEMAN C.F.P.P.
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5832
1639578255 JUANITA HERRERA
Individual
Counselor (Mental Health)13136 WESTERN AVE
BLUE ISLAND, IL 60406
(773) 407-6117
1508265877 TRANESE PERRYMAN
Individual
Case Manager/Care Coordinator13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5862
1972902237 SANDRA KAWCZYNSKI
Individual
Case Manager/Care Coordinator13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5815
1669860243 CYNTHIA GRADY
Individual
Case Manager/Care Coordinator13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5815
1295123891 HEATHER TURNELIUS
Individual
Case Manager/Care Coordinator13136 WESTERN AVE
BLUE ISLAND, IL 60406
(708) 974-5815

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285929620, enumerated in the NPI registry as an "individual" on June 14, 2011

The provider is located at 13136 Western Ave Blue Island, Il 60406 and the phone number is (708) 974-5800

The provider's speciality is Registered Nurse with taxonomy code 163W00000X

The provider might be accepting Accepts: Blue Cross and Blue Shield of Illinois. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.

This NPI record was last updated on June 14, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.