IndividualActive
Jared Willard, M.D.
NPI 1619362852 · Sports Medicine (Internal Medicine) Physician · Champaign, IL
Provider details
- NPI number
- 1619362852
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 0000058974 (TN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
3101 Fields South Dr
Champaign, IL 61822-3743
Phone: (217) 366-1237
Fax: (217) 366-1303
Approximate (ZIP-level) locationGet directions
Mailing address
101 W University Ave
Champaign, IL 61820-3981
Registry dates
- Enumerated
- 2015-04-04
- Last updated
- 2025-06-03
- Certified
- 2025-06-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.