Illig, Lisa Christine
Illig, Lisa Christine is an individual health care provider with primary practice located at 6500 Excelsior Blvd , St Louis Park MN 55426-4702. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, which is considered as her primary health care specialty. Illig, Lisa Christine can be contacted via phone (952) 993-0121.Contact Information
Primary practice address
6500 Excelsior Blvd
St Louis Park MN 55426-4702
Phone: (952) 993-0121
Fax: (952) 993-1456
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207RH0002X | 52246 | Minnesota |
Profile Details
NPI number | 1235177932 |
---|---|
LBN Legal business name | Illig, Lisa Christine |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 3rd, 2006 |
Last updated | Oct 13th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1235177932 | NPPES |
Virginia | Other | 209808 | SOUTHERN HEALTH |
Virginia | Other | P00074226 | SOUTHERN HEALTH |
Virginia | MEDICAID | 005884641 | SOUTHERN HEALTH |
Virginia | Other | 2959204001 | SOUTHERN HEALTH |
Virginia | Other | 64758 | SOUTHERN HEALTH |
Virginia | MEDICAID | 64758 | SOUTHERN HEALTH |
Virginia | MEDICAID | 00554641 | SOUTHERN HEALTH |
Virginia | Other | 278633 | SOUTHERN HEALTH |
Virginia | MEDICAID | 278633 | SOUTHERN HEALTH |
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