JENNIFER M ILLIG (NPI# 1245335660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245335660 |
| Entity Type | Individual |
| Full Name | JENNIFER M ILLIG |
| Other Name | JENNIFER MARIE LONG |
| Credential | PAC |
| Practice Address |
1850 E Park Ave Ste 201 State College PA 16803-6706 |
| Practice Telephone | 8442784600 |
| Practice Fax Number | 8142351133 |
| Mailing Telephone | 8442784600 |
| Mailing Fax Number | 8142351133 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA052572 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790292076 | Jennifer Lynn Illig | Social Worker | 138 Gerloff Rd, Schwenksville, PA 19473-1719 | 2018-01-08 |
| Street Address |
1850 E PARK AVE STE 201 |
| City | STATE COLLEGE |
| State | PA |
| Zip Code | 16803-6706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548249642 | Gregory A Ruff | Internal Medicine | 1850 E Park Ave Ste 201, State College, PA 16803-6706 | 2006-01-17 |
| 1366948192 | Janet R Cady | Nurse Practitioner | 1850 E Park Ave Ste 201, State College, PA 16803 | 2018-04-02 |
| 1992157945 | Helen M Martin | Nurse Practitioner | 1850 E Park Ave Ste 201, State College, PA 16803-6706 | 2016-07-01 |
| 1932567013 | Muqueet Kadri | Internal Medicine | 1850 E Park Ave Ste 201, State College, PA 16803 | 2016-02-04 |
| 1316387939 | Shyama Dilani Wickramaaratchi | Internal Medicine | 1850 E Park Ave Ste 201, State College, PA 16803 | 2013-06-27 |
| 1821437328 | Vyacheslav Vilensky | Internal Medicine | 1850 E Park Ave Ste 201, State College, PA 16803-6706 | 2013-06-18 |
| 1275670028 | Faoud Ishmael | Allergy & Immunology | 1850 E Park Ave Ste 201, State College, PA 16803 | 2007-01-31 |
| 1215965520 | Steven M Smith | Physician Assistant | 1850 E Park Ave Ste 201, State College, PA 16803-6706 | 2006-06-28 |
| 1891744470 | Thomas Wayne Waddington | Internal Medicine | 1850 E Park Ave Ste 201, State College, PA 16803 | 2006-05-09 |
| 1548236896 | Jeffrey A Ratner | Internal Medicine | 1850 E Park Ave Ste 201, State College, PA 16803-6706 | 2006-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851581 | Tammy Lynn Terosky | Massage Therapist | 2134 Sandy Drive, Suite 6, State College, PA 16803 | 2020-08-12 |
| 1548748973 | Molly Gomez | Occupational Therapist | 260 Lions Hill Road, State College, PA 16803 | 2018-07-28 |
| 1568981827 | David Scott Kautz | Pharmacist | 1665 North Atherton Place, State College, PA 16803 | 2017-09-18 |
| 1245751023 | Zenovia Tarmohamed | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, Penn State Health At Mount Nittany Medical Center, State College, PA 16803 | 2017-06-30 |
| 1407205362 | Alka Sood | Student in an Organized Health Care Education/Training Program | 1850 E. Park Avenue, State College, PA 16803 | 2016-06-10 |
| 1588018766 | Daniel Frankel | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, State College, PA 16803 | 2016-04-14 |
| 1154791903 | Megan Widener | Physician Assistant | 2520 Green Tech Dr., Ste. D, State College, PA 16803 | 2015-10-05 |
| 1114301330 | Phuong Tran Courtney | Physician Assistant | 1613 North Atherton Street, Suite B, State College, PA 16803 | 2015-07-17 |
| 1164806840 | Amit Thatte | Student in an Organized Health Care Education/Training Program | 1850 East Park Ave., Suite 207, Penn State Hershey Medical Group, State College, PA 16803 | 2015-07-13 |
| 1245588946 | Phoenix Rehabilitation and Health Services, Inc. | Chiropractor | 1700 Old Gatesburg Road, Suite 210, State College, PA 16803 | 2012-08-28 |
| Find all providers in zip 16803 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245261643 | Rose Therese Villarreal | Physician Assistant | 611 University Dr Ste 210, State College, PA 16801 | 2006-07-05 |
| 1386245827 | Sarah Elizabeth Westin | Physician Assistant | 1526 Martin St, State College, PA 16803-3058 | 2020-11-02 |
| 1992180053 | Shauna Landrey | Physician Assistant | 1800 E Park Ave, State College, PA 16803-6709 | 2015-07-29 |
| 1679973044 | Hans D. Reisinger | Physician Assistant | 1700 Old Gatesburg Rd Ste 310, State College, PA 16803-2276 | 2014-09-03 |
| 1669654463 | Angela P Urban | Physician Assistant | 1800 E Park Ave, State College, PA 16803-6709 | 2007-12-04 |
| 1720154610 | Todd E. Brunermer | Physician Assistant | 101 Regent Ct, State College, PA 16801-7965 | 2006-11-24 |
| 1821184391 | Sara Margaret Tyson | Physician Assistant | 1850 E Park Ave, Ste 201, State College, PA 16803-6706 | 2006-10-04 |
| 1598860843 | Shawn L Kibe | Physician Assistant | 101 Regent Ct, State College, PA 16801-7965 | 2006-09-13 |
| 1528163797 | Erin Elizabeth Gilroy | Physician Assistant | 476 Rolling Ridge Dr, Suite 200, State College, PA 16801-7639 | 2006-09-13 |
| 1598728495 | Caryl L. Waite | Physician Assistant | 3901 S Atherton St, Suite 5, State College, PA 16801-8324 | 2006-04-11 |
| Find all providers in STATE COLLEGE | ||||
| City | STATE COLLEGE |
| Zip Code | 16803 |
Please comment or provide details below to improve the information on JENNIFER M ILLIG.
| 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.