Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jerrold C Willis, MD

Individual provider Diagnostic Radiology Physician · NPI 1467407072

Dr. Jerrold C Willis, MD is a Diagnostic Radiology in Mount Vernon, Illinois. Graduated from Southern Illinois University School of Medicine in 1977, 49 years ago. Practices with Crawford Hospital District, a 73-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
49
Trained at
Southern Illinois University School of Medicine
Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1 Good Samaritan Way Radiology Dept
Mount Vernon, IL 62864-2402
Phone: (618) 242-4600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 36057038 (IL)

Record details

NPI number1467407072
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 23, 2006
Last updated in NPPESMarch 15, 2021
Certification dateMarch 15, 2021
Mailing addressPo Box 2153 Dept 20002, Birmingham, AL 35287-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Also practisesINTERVENTIONAL RADIOLOGY, NUCLEAR MEDICINE
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1977 (49 years in practice)
Group practice Crawford Hospital District — 73 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Mount Vernon