Ilustre, Joanne Marie
Ilustre, Joanne Marie is an individual health care provider with primary practice located at 1 Bartol Ave Ste 10 , Ridley Park PA 19078-2214. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Ilustre, Joanne Marie can be contacted via phone (610) 521-0150.Contact Information
Primary practice address
1 Bartol Ave Ste 10
Ridley Park PA 19078-2214
Phone: (610) 521-0150
Fax: (610) 521-6493
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | C20011444 | Delaware |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | OS015002 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | OS015002 | Pennsylvania |
Profile Details
| NPI number | 1750545661 |
|---|---|
| LBN Legal business name | Ilustre, Joanne Marie |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2008 |
| Last updated | Jan 6th, 2021 - about 3 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 | 1750545661 | NPPES |
| Pennsylvania | MEDICAID | 1035757110003 |
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