MRS. STEPHANIE LYNN ILLIAN (NPI# 1285991356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285991356 |
| Entity Type | Individual |
| Full Name | MRS. STEPHANIE LYNN ILLIAN |
| Credential | PA-C |
| Practice Address |
1 William Carls Dr Ste 120 Commerce Township MI 48382-2201 |
| Mailing Address |
16208 Baldwin Cir Holly MI 48442-9384 |
| Practice Telephone | 2489374947 |
| Mailing Telephone | 5862153273 |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601006316 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 WILLIAM CARLS DR STE 120 |
| City | COMMERCE TOWNSHIP |
| State | MI |
| Zip Code | 48382-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477546059 | Diana Guerrero Betancourt | Internal Medicine | 1 William Carls Dr, Huron Valley Sinai Hospital, Commerce Township, MI 48382-2201 | 2005-08-29 |
| 1063028728 | Northwest Surgical Plc | Surgery | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2020-09-18 |
| 1306469366 | Sameer Singh Sethi | Student in an Organized Health Care Education/Training Program | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2020-05-26 |
| 1578184362 | Jeffery Lei | Student in an Organized Health Care Education/Training Program | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2020-05-03 |
| 1770103186 | Joseph Bret Owens | Student in an Organized Health Care Education/Training Program | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2020-04-26 |
| 1265052849 | Meagan Marshall | Student in an Organized Health Care Education/Training Program | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2020-04-23 |
| 1407476054 | Sandra Apeksha Wijekularatne | Student in an Organized Health Care Education/Training Program | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2020-04-23 |
| 1922662998 | Erica St.lawrence | Student in an Organized Health Care Education/Training Program | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2019-04-25 |
| 1720642622 | Katherine Swords | Student in an Organized Health Care Education/Training Program | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2019-04-25 |
| 1811469208 | Darren Trippell | Physician Assistant | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2018-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700373933 | Kevin Piper | Occupational Therapist | 3517 Clark Circle, Commerce, MI 48382 | 2018-04-13 |
| 1215483953 | Jodi Lynn Van Proeyen | Community Health Worker | 8749 Buckskin Drive, Commerce Township, MI 48382 | 2016-09-01 |
| 1912382532 | Lindsay Anne Brossy | Nurse Practitioner | 8906 Commerce Rd Unit 5, Commerce Twp, MI 48382 | 2015-07-24 |
| 1386991008 | Joao Najar | Dentist | 1440 Woodview Lane, Commerce, MI 48382 | 2012-08-13 |
| 1275828709 | Stacy Ann Madany | Physician Assistant | 9640 Commerce Road, Suite 100, Commerce, MI 48382 | 2011-06-13 |
| 1801038740 | Kent C. Bowden Do Pllc | Surgery | 1 William Carls Drive, Huron Valley Sinai Hospital, Commerce, MI 48382 | 2009-03-24 |
| 1982895207 | Stephanie Lee Adams | Specialist/Technologist | 8391 E. Commerce Rd., Suite 108, Commerce Township, MI 48382 | 2007-08-05 |
| 1780890459 | William Lee Thompson | Dentist | 2900 Union Lake Rd Ste 105, Commerce Township, MI 48382 | 2007-05-16 |
| 1184836082 | Kadima Jewish Support Services for Adults With Mental Illness | Community/Behavioral Health | 15999 West 12 Mile Road, Southfield, MI 48382 | 2007-05-04 |
| 1821132945 | Alan Elliot Parven | Optometrist | 3000 Commerce Crossing Rd, Commerce Township, MI 48382 | 2007-02-20 |
| Find all providers in zip 48382 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811469208 | Darren Trippell | Physician Assistant | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2018-12-22 |
| 1336257765 | Christian B Gentry | Physician Assistant | 1 William Carls Dr, Commerce Township, MI 48382-2201 | 2006-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835303 | Gerard M Lefebvre Jr. | Physician Assistant | 5301 Mcauley Dr Ste 5112, Ypsilanti, MI 48197-1051 | 2019-11-08 |
| 1548611023 | Michael Scott Schaeffer II | Physician Assistant | 58070 Montego Dr, New Hudson, MI 48165-9735 | 2016-06-27 |
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881052363 | Surgical Assist, Plc | Physician Assistant | 4409 Gaylord Dr, Troy, MI 48098-4458 | 2016-01-29 |
| 1710342134 | Evan Reid Vandenbosch | Physician Assistant | 36622 5 Mile Rd, Suite 101, Livonia, MI 48154-1900 | 2015-12-30 |
| 1619368008 | Matthew Eisen | Physician Assistant | 1560 E Sherman Blvd Ste 9, Muskegon, MI 49444-1867 | 2015-02-06 |
| 1609214972 | Jennifer Lynn Krishnan | Physician Assistant | 3601 E 13 Mile Rd, Royal Oak, MI 48073-6769 | 2013-06-10 |
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1669707170 | Luke Thomas Dillon | Physician Assistant | 3100 Cross Creek Pkwy Ste 200, Auburn Hills, MI 48326-2776 | 2009-10-16 |
| 1912139544 | Richard Lawrence Burgett Sr. | Physician Assistant | 4327 Stone Ridge Dr, Traverse City, MI 49684-7958 | 2009-08-15 |
| Find all providers with the same taxonomy | ||||
| City | COMMERCE TOWNSHIP |
| Zip Code | 48382 |
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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.