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

Dr. Willis Ko, MD

Individual provider Interventional Cardiology Physician · NPI 1215465307

Dr. Willis Ko, MD is an Interventional Cardiology in Maryville, Illinois. Qualified in 2017, 9 years ago. Practices with Fairview Heights Medical Group SC, a 448-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois, Missouri and Pennsylvania.

Years since qualifying
9
Licensed in
IL, MO, PA
In the registry since
2017
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

6810 State Route 162 Ste 102B
Maryville, IL 62062-8560
Phone: (618) 288-4076
Fax: (618) 288-4215
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 201 14th St Sw, Largo, FL 33770-3133 — (727) 588-3700
  • 5645 Main St, Flushing, NY 11355-5045 — (718) 670-2000
  • 230 N Broad Street, Philadelphia, PA 19102 — (215) 762-7000

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 036171090 (IL)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence MT213475 (PA)
Internal Medicine Physician Taxonomy 207R00000X · Licence MT213475 (PA)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 2024024174 (MO)

Record details

NPI number1215465307
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 1, 2017
Last updated in NPPESSeptember 19, 2025
Certification dateSeptember 19, 2025
Mailing address660 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8512

Medicare enrollment

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

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Fairview Heights Medical Group Sc — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare