WILLIS KO MD – NPI #1215465307
Internal Medicine

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Health Care Provider Taxonomy Code for Internal Medicine

WILLIS KO is a physician located in MARYVILLE, IL. NPPES has assigned the NPI number 1215465307 to WILLIS KO on June 01, 2017. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI data, there are 3 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RI0011X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Interventional Cardiology

The NPI profile was last updated on Sep 19, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WILLIS KO below.

NPI Profile for
WILLIS KO

NPI Number
1215465307
Enumeration Date

(more than 9 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
WILLIS KO
Credentials
MD
Primary location
6810 STATE ROUTE 162 STE 102B
MARYVILLE, IL 62062-8560
Phone: (618) 288-4076 Fax: (618) 288-4215
3 Other location(s):
201 14th St SW
Largo, FL 33770-3133
Phone: (727) 588-3700
Fax: (727) 585-7205
5645 Main St
Flushing, NY 11355-5045
Phone: (718) 670-2000
230 N Broad Street
Hahnemann University Hospital
Philadelphia, PA 19102
Phone: (215) 762-7000
Mailing address
660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO 63141-8512
Phone: (314) 448-3791 Fax: (314) 996-7658
Sole Proprietor
No
Updated
Certification Date
Sep 19, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RI0011X
- Internal Medicine / Interventional Cardiology (Primary)		 IL 036171090
207RC0000X
- Internal Medicine / Cardiovascular Disease		 PA MT213475
207R00000X
- Internal Medicine		 PA MT213475

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
Y
Endpoint Location
5645 MAIN ST,
FLUSHING, NY 77025-1669
Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Endpoint type
FHIR URL
Endpoint Description
BJC
Content Type
CSV
Affiliation
N
Endpoint Location
6810 STATE ROUTE 162 STE 102B,
MARYVILLE, IL 77025-1669

Additional Information

Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.