Perepelitsyn, Ilya

Perepelitsyn, Ilya is an individual health care provider with primary practice located at 2211 Park Ave , Minneapolis MN 55404-3711. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, which is considered as his primary health care specialty. Perepelitsyn, Ilya can be contacted via phone (612) 871-1144.

Contact Information

Primary practice address
2211 Park Ave Minneapolis MN 55404-3711
Phone: (612) 871-1144
Fax: (612) 871-2012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 219565 Massachusetts
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 49351 Minnesota

Profile Details

NPI number 1992795058
LBN Legal business name Perepelitsyn, Ilya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated Jun 13th, 2013 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992795058 NPPES
Minnesota MEDICAID 305473200
Minnesota Other AA11436
Minnesota Other J27270
Minnesota MEDICAID 34756700

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