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:
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Health care specialties

SpecialtyCodeLicense #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 15 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.

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Identifiers

StateTypeNumberIssuer
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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