DR. LISA CHRISTINE ILLIG


Address: 6500 Excelsior Blvd, St Louis Park, MN 55426-4702
Phone: 9529930121

DR. LISA CHRISTINE ILLIG (NPI# 1235177932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235177932
Entity Type Individual
Full Name DR. LISA CHRISTINE ILLIG
Credential MD
Practice Address 6500 Excelsior Blvd
St Louis Park
MN 55426-4702
Practice Telephone 9529930121
Practice Fax Number 9529931456
Mailing Telephone 9529930121
Mailing Fax Number 9529931456
Enumeration Date 2006-06-03
Last Update Date 2011-10-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0002X Internal Medicine
Specialization: Hospice and Palliative Medicine
52246 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VA 278633 05
VA COMMUNITY HEALTH 64758 01
VA 64758 05
VA MEDICARE PIN P00074226 01
VA 005884641 05
VA SOUTHERN HEALTH 209808 01
VA 00554641 05
VA ANTHEM SVCS/HEALTHKEEPERS 278633 01
VA CIGNA 2959204001 01

Office Location

Street Address 6500 EXCELSIOR BLVD
City ST LOUIS PARK
State MN
Zip Code 55426-4702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1861484669 Robert E Haselow Radiology 6500 Excelsior Blvd, Methodist Radiation Therapy, St Louis Park, MN 55426-4702 2005-08-17
1215549381 Katelyn Boys Physical Therapist 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 2020-08-20
1386253466 Christine Harlander Physical Therapist 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 2020-07-24
1063021210 Ian-thomas Campbell-groen Physical Therapist 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 2020-07-23
1619585387 Kelly Faber Physical Therapist 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 2020-07-20
1952938821 Paige Rygg Physical Therapist 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 2020-03-23
1801427406 Brandi Jo St. Mane Nurse Anesthetist, Certified Registered 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 2020-02-01
1811528680 Brian Servey IIi Nurse Anesthetist, Certified Registered 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 2020-01-30
1245873421 Weston Poucher Nurse Anesthetist, Certified Registered 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 2019-10-21
1427609973 Lauren Damrow Registered Nurse 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 2019-09-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821657545 Big Brain Concussion Recovery & Chiropractic Pa Chiropractor 3313 Republic Ave., St. Louis Park, MN 55426 2019-06-06
1912485095 Daniel Raies Optometrist 8900 Minnesota 7, St Louis Park, MN 55426 2018-08-01
1649756040 Wayside House, Inc. Clinic/Center 1349 Jersey Ave S, St. Louis Park, MN 55426 2018-07-18
1104302884 Superior Caregivers, LLC In Home Supportive Care 1319 Lancaster Ave., St. Louis Park, MN 55426 2018-07-16
1396234266 Caitlin Kwiatkowski Behavior Technician 7010 Mn-7, St.louis Park, MN 55426 2018-05-07
1497244313 Kelly Ann Clancey Behavior Technician 7010 Highway 2, Saint Louis Park, MN 55426 2018-05-07
1770072696 Ashleigh Hakala Behavior Technician 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 2018-05-07
1689181521 Glenda Miles Registered Nurse 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 2017-12-31
1174041875 Kristen Webb Physician Assistant 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 2017-09-01
1447775549 Belinda Sue Bliss Marriage & Family Therapist 3301 Decatur Lane, Saint Louis Park, MN 55426 2017-08-09
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Taxonomy Information

Taxonomy Code 207RH0002X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hospice and Palliative Medicine

Taxonomy Definition

An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104801455 Steven Duane Internal Medicine 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 2005-12-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1134751274 Specialized Medical Response, LLC Internal Medicine 401 Harding St Ne Ste 100, Minneapolis, MN 55413-2801 2020-02-06
1598230138 Allina Health System Internal Medicine 1055 Westgate Dr Ste 100, Saint Paul, MN 55114-1451 2018-10-10
1780117192 Taryn Green Internal Medicine 200 1st St Sw, Rochester, MN 55905-0001 2017-04-04
1063828150 Daniel Kent Partain Internal Medicine 200 1st St Sw, Rochester, MN 55905 2014-07-09
1609215607 Sara Suleman Internal Medicine 1025 Marsh St, Mankato, MN 56001-4752 2013-06-23
1356669394 Elizabeth Nassef Jeffrey Internal Medicine 420 Delaware St Se, Mayo Bldg B344, Mmc 603, Minneapolis, MN 55455-0341 2010-05-14
1578889424 Emily Schafhauser Internal Medicine 345 Sherman St Ste 100, Saint Paul, MN 55102-2401 2010-04-18
1396988614 James John Tiede Internal Medicine 301 Becker Ave Sw, Willmar, MN 56201-3302 2009-04-16
1992755151 Molly A. Feely Internal Medicine 200 1st St Sw, Rochester, MN 55905 2006-05-10

Competitor

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City ST LOUIS PARK
Zip Code 55426

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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