Zachary Nicholas Illg
Emergency Medicine in Atlanta, GA. Individual provider (NPI-1).
NPI number1073017232
StatusActive
Last updated in NPPESApr 21, 2022
Details
- NPI
- 1073017232
- Entity type
- Individual (NPI-1)
- Name
- Zachary Nicholas Illg
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2018
- Certification date
- Apr 21, 2022
- Last updated
- Apr 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 88589 | GA | Yes |
| 207P00000X | Emergency Medicine | 5151013211 | MI | |
| 207P00000X | Emergency Medicine | 5101023831 | MI |
Practice location
303 Parkway Dr NeAtlanta, GA 30312-1212
Phone 404-265-4000
Mailing address
2110 47th StDes Moines, IA 50310-3045
Phone 515-883-0464
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