Provider Demographics
NPI:1023218070
Name:ELYEA, WILLARD O (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:O
Last Name:ELYEA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9000 N LINDBERGH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-1417
Mailing Address - Country:US
Mailing Address - Phone:309-272-1582
Mailing Address - Fax:309-272-1583
Practice Address - Street 1:2848 MCDONOUGH ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60436-1050
Practice Address - Country:US
Practice Address - Phone:815-725-1206
Practice Address - Fax:815-741-1579
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
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Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine