Dr. Rudolph Willis, MD
Family Medicine in Irvington, New Jersey
1104887819- Practice location
- 12 Krotik Pl, Irvington Emergent Care And Rehabilitation Center INC., Irvington, NJ 07111-1708
- Phone
- 973-373-3000
- Fax
- —
- Last updated
- March 10, 2026
Rudolph Willis is a Family Medicine based in Irvington, NJ. Rudolph Willis practices in Irvington, NJ and has the professional credentials of MD. The NPI Number for Rudolph Willis is 1104887819 and holds a License No. MA42750 (NJ). The current practice location address for Rudolph Willis is 12 Krotik Pl, Irvington Emergent Care And Rehabilitation Center INC., Irvington, NJ 07111-1708 and can be reached out via phone at 973-373-3000.
Provider Profile Details
- NPI Number
- 1104887819
- Provider Name
- Rudolph Willis
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 12 Krotik Pl, Irvington Emergent Care And Rehabilitation Center INC., Irvington, NJ 07111-1708
- Phone Number
- 973-373-3000
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 31, 2006
- Last Update Date
- March 10, 2026
- Certification Date
- March 10, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 12 Krotik Pl
Irvington Emergent Care And Rehabilitation Center INC.
Irvington, NJ 07111-1708 - City
- Irvington
- State
- New Jersey
- Zip
- 07111-1708
- Phone Number
- 973-373-3000
Provider Business Mailing Address Details
- Address
- 12 Krotik Pl
Irvington Emergent Care And Rehabilitation Center INC.
Irvington, NJ 07111-1708 - City
- Irvington
- State
- NJ
- Zip
- 07111-1708
- Phone Number
- 973-373-3000
License Information
- License Number (1)
- MA42750
- License State (1)
- NJ
- Taxonomy (1)
- Specialist · 174400000X
- License Number (2)
- 25MA04275000
- License State (2)
- NJ
- Taxonomy (2)
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Rudolph Willis, MD?
The NPI number of Dr. Rudolph Willis, MD is 1104887819. It was assigned on March 31, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Rudolph Willis, MD?
Dr. Rudolph Willis, MD is registered under the primary taxonomy Family Medicine (code 207Q00000X), licensed in NJ under license number MA42750.
Where does Dr. Rudolph Willis, MD practice?
The practice location is 12 Krotik Pl, Irvington Emergent Care And Rehabilitation Center INC., Irvington, NJ 07111-1708. The office can be reached at 973-373-3000 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104887819 directly on the NPPES registry website.