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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
52246 | MN | Allopathic & Osteopathic Physicians |
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 |
Street Address |
6500 EXCELSIOR BLVD |
City | ST LOUIS PARK |
State | MN |
Zip Code | 55426-4702 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 55426 |
Taxonomy Code | 207RH0002X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Hospice and Palliative Medicine |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104801455 | Steven Duane | Internal Medicine | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2005-12-09 |
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 |
City | ST LOUIS PARK |
Zip Code | 55426 |
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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.